[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:01.21,0:00:03.90,Default,,0000,0000,0000,,What's the worst that can happen?
Dialogue: 0,0:00:04.29,0:00:06.79,Default,,0000,0000,0000,,Almost exactly 10 years ago,
Dialogue: 0,0:00:06.79,0:00:10.50,Default,,0000,0000,0000,,I was sitting in an exam room\Nthat was way too cold
Dialogue: 0,0:00:10.50,0:00:12.84,Default,,0000,0000,0000,,waiting to meet my new oncologist.
Dialogue: 0,0:00:13.06,0:00:14.44,Default,,0000,0000,0000,,I was terrified.
Dialogue: 0,0:00:14.44,0:00:17.00,Default,,0000,0000,0000,,Even though my partner at the time
Dialogue: 0,0:00:17.00,0:00:19.12,Default,,0000,0000,0000,,was sitting right by my side,
Dialogue: 0,0:00:19.12,0:00:21.67,Default,,0000,0000,0000,,I felt completely alone.
Dialogue: 0,0:00:21.67,0:00:24.49,Default,,0000,0000,0000,,I had just been diagnosed\Nwith breast cancer,
Dialogue: 0,0:00:24.49,0:00:26.54,Default,,0000,0000,0000,,and it seemed at the time
Dialogue: 0,0:00:26.54,0:00:29.80,Default,,0000,0000,0000,,that a single bright spot\Non a scan of my right lung
Dialogue: 0,0:00:30.16,0:00:33.54,Default,,0000,0000,0000,,meant that the cancer had already spread.
Dialogue: 0,0:00:33.94,0:00:36.53,Default,,0000,0000,0000,,I had metastatic breast cancer.
Dialogue: 0,0:00:36.92,0:00:39.40,Default,,0000,0000,0000,,I had no medical training at this point,
Dialogue: 0,0:00:39.40,0:00:42.34,Default,,0000,0000,0000,,but I knew what it meant if it were true:
Dialogue: 0,0:00:42.34,0:00:44.92,Default,,0000,0000,0000,,incurable breast cancer.
Dialogue: 0,0:00:45.85,0:00:48.37,Default,,0000,0000,0000,,Terminal breast cancer.
Dialogue: 0,0:00:49.22,0:00:51.70,Default,,0000,0000,0000,,I was 27 years old,
Dialogue: 0,0:00:51.70,0:00:54.29,Default,,0000,0000,0000,,had just been accepted to medical school,
Dialogue: 0,0:00:54.29,0:00:58.65,Default,,0000,0000,0000,,and I wondered if I was already\Nat the end of my life.
Dialogue: 0,0:00:58.65,0:01:03.22,Default,,0000,0000,0000,,My new oncologist was not a warm person.
Dialogue: 0,0:01:03.87,0:01:06.100,Default,,0000,0000,0000,,She dealt in simple facts,
Dialogue: 0,0:01:06.100,0:01:09.83,Default,,0000,0000,0000,,as many brilliant physicians do.
Dialogue: 0,0:01:10.02,0:01:13.19,Default,,0000,0000,0000,,"Our body is made up\Nof cells," she started.
Dialogue: 0,0:01:13.19,0:01:15.100,Default,,0000,0000,0000,,I stopped her.
Dialogue: 0,0:01:15.100,0:01:18.60,Default,,0000,0000,0000,,"I'm starting medical school soon.
Dialogue: 0,0:01:18.60,0:01:20.47,Default,,0000,0000,0000,,I know."
Dialogue: 0,0:01:20.47,0:01:25.02,Default,,0000,0000,0000,,Instead of taking this as a signal\Nto go backward, to start again,
Dialogue: 0,0:01:25.02,0:01:27.46,Default,,0000,0000,0000,,she went forward.
Dialogue: 0,0:01:27.46,0:01:30.08,Default,,0000,0000,0000,,She said that I would need\Nto start on chemotherapy
Dialogue: 0,0:01:30.08,0:01:31.37,Default,,0000,0000,0000,,to control the cancer.
Dialogue: 0,0:01:31.37,0:01:34.99,Default,,0000,0000,0000,,She launched into the details\Nof the drug and the side effects
Dialogue: 0,0:01:34.99,0:01:36.44,Default,,0000,0000,0000,,and the schedule.
Dialogue: 0,0:01:36.44,0:01:40.80,Default,,0000,0000,0000,,I reminded her that we hadn't even yet\Nbiopsied the bright spot on my lung,
Dialogue: 0,0:01:40.80,0:01:44.47,Default,,0000,0000,0000,,and I asked if she was sure\Nthat it was cancer.
Dialogue: 0,0:01:45.42,0:01:50.91,Default,,0000,0000,0000,,I remember viscerally how she seemed\Nalmost frustrated with my question.
Dialogue: 0,0:01:50.91,0:01:54.49,Default,,0000,0000,0000,,Perhaps she thought I wasn't\Nfollowing along with her explanations,
Dialogue: 0,0:01:54.49,0:01:56.83,Default,,0000,0000,0000,,or, worse still, I was in denial.
Dialogue: 0,0:01:58.17,0:02:01.59,Default,,0000,0000,0000,,I simply wanted her to understand\Nthat, as her patient,
Dialogue: 0,0:02:01.59,0:02:06.90,Default,,0000,0000,0000,,the biopsy was not just a mere formality\Nto prove an already foregone conclusion.
Dialogue: 0,0:02:06.90,0:02:11.17,Default,,0000,0000,0000,,It was a steel needle\Nthrough skin, muscle and bone
Dialogue: 0,0:02:11.17,0:02:15.65,Default,,0000,0000,0000,,that would deliver a deep piece of me\Nto the surface and answer a question
Dialogue: 0,0:02:15.65,0:02:18.36,Default,,0000,0000,0000,,I wish didn't have to be asked.
Dialogue: 0,0:02:18.65,0:02:22.67,Default,,0000,0000,0000,,Before the biopsy, I could be\Na 27-year old woman
Dialogue: 0,0:02:22.67,0:02:25.81,Default,,0000,0000,0000,,who might have metastatic breast cancer,
Dialogue: 0,0:02:25.81,0:02:29.20,Default,,0000,0000,0000,,who probably had metastatic breast cancer.
Dialogue: 0,0:02:29.20,0:02:31.77,Default,,0000,0000,0000,,This is a critical distinction,
Dialogue: 0,0:02:31.77,0:02:35.89,Default,,0000,0000,0000,,but it's not one that's emphasized\Nin the most elite oncology training.
Dialogue: 0,0:02:36.25,0:02:41.10,Default,,0000,0000,0000,,Instead, I was dismissed\Nwith an appointment to start treatment
Dialogue: 0,0:02:41.10,0:02:42.82,Default,,0000,0000,0000,,in just a few weeks.
Dialogue: 0,0:02:43.57,0:02:47.33,Default,,0000,0000,0000,,So much has happened\Nsince that first visit.
Dialogue: 0,0:02:47.33,0:02:50.79,Default,,0000,0000,0000,,Ironically, the biopsy was not\Njust a mere formality.
Dialogue: 0,0:02:50.79,0:02:53.57,Default,,0000,0000,0000,,My former oncologist was right.
Dialogue: 0,0:02:53.57,0:02:56.30,Default,,0000,0000,0000,,It did show cancer,
Dialogue: 0,0:02:56.30,0:03:00.30,Default,,0000,0000,0000,,but it was a totally separate lung cancer,
Dialogue: 0,0:03:00.30,0:03:02.50,Default,,0000,0000,0000,,and as crazy as it sounds,
Dialogue: 0,0:03:02.50,0:03:04.78,Default,,0000,0000,0000,,this was great news.
Dialogue: 0,0:03:04.99,0:03:08.18,Default,,0000,0000,0000,,I did not have metastatic breast cancer,
Dialogue: 0,0:03:08.18,0:03:10.03,Default,,0000,0000,0000,,I had two different cancers,
Dialogue: 0,0:03:10.03,0:03:12.13,Default,,0000,0000,0000,,but both of them were localized,
Dialogue: 0,0:03:12.13,0:03:15.38,Default,,0000,0000,0000,,and so the lung cancer\Nwas localized enough
Dialogue: 0,0:03:15.38,0:03:16.93,Default,,0000,0000,0000,,that it could be removed.
Dialogue: 0,0:03:16.93,0:03:20.58,Default,,0000,0000,0000,,And so the onslaught of treatments began\Nwith a lung surgery,
Dialogue: 0,0:03:20.58,0:03:23.07,Default,,0000,0000,0000,,continued with chemotherapy,
Dialogue: 0,0:03:23.07,0:03:27.81,Default,,0000,0000,0000,,and ended with a breast surgery\Njust after my 28th birthday.
Dialogue: 0,0:03:27.81,0:03:29.82,Default,,0000,0000,0000,,And then two weeks later,
Dialogue: 0,0:03:29.82,0:03:32.87,Default,,0000,0000,0000,,I started medical school.
Dialogue: 0,0:03:32.87,0:03:35.98,Default,,0000,0000,0000,,My new oncologist,
Dialogue: 0,0:03:35.98,0:03:40.06,Default,,0000,0000,0000,,who deals much more fluidly\Nboth with facts and their implications,
Dialogue: 0,0:03:40.53,0:03:42.58,Default,,0000,0000,0000,,very reasonably suggested
Dialogue: 0,0:03:42.58,0:03:45.88,Default,,0000,0000,0000,,that I should defer my acceptance\Nto medical school for a year,
Dialogue: 0,0:03:45.88,0:03:49.01,Default,,0000,0000,0000,,take some time to rest, to recover,
Dialogue: 0,0:03:49.01,0:03:52.75,Default,,0000,0000,0000,,and I trusted her advice.
Dialogue: 0,0:03:52.75,0:03:56.74,Default,,0000,0000,0000,,I felt terrible during the intensive\Nchemotherapy sessions.
Dialogue: 0,0:03:56.74,0:03:58.46,Default,,0000,0000,0000,,And so I wrote to the Dean.
Dialogue: 0,0:03:58.46,0:04:00.35,Default,,0000,0000,0000,,I explained my circumstances,
Dialogue: 0,0:04:00.35,0:04:02.65,Default,,0000,0000,0000,,and a deferral was speedily granted.
Dialogue: 0,0:04:03.68,0:04:06.19,Default,,0000,0000,0000,,But as the chemo fog lifted,
Dialogue: 0,0:04:06.19,0:04:09.48,Default,,0000,0000,0000,,I wondered what I was going\Nto do with a year.
Dialogue: 0,0:04:09.48,0:04:12.85,Default,,0000,0000,0000,,Should I go to the beach?
Dialogue: 0,0:04:13.28,0:04:15.100,Default,,0000,0000,0000,,I wasn't really a beach person.
Dialogue: 0,0:04:15.100,0:04:17.10,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:04:17.10,0:04:20.40,Default,,0000,0000,0000,,And how many years did I have left anyway?
Dialogue: 0,0:04:21.15,0:04:23.51,Default,,0000,0000,0000,,I really wanted to go to medical school.
Dialogue: 0,0:04:23.51,0:04:26.65,Default,,0000,0000,0000,,It seemed like a missing\Npiece of my puzzle.
Dialogue: 0,0:04:26.85,0:04:30.70,Default,,0000,0000,0000,,So instead of going around\Nand around with indecision,
Dialogue: 0,0:04:30.70,0:04:33.61,Default,,0000,0000,0000,,I asked myself, what's the worst\Nthat could happen?
Dialogue: 0,0:04:33.61,0:04:37.06,Default,,0000,0000,0000,,Well, I could be too weak\Nor too sick to do the work.
Dialogue: 0,0:04:37.06,0:04:39.47,Default,,0000,0000,0000,,It could be too hard for me emotionally.
Dialogue: 0,0:04:39.47,0:04:42.44,Default,,0000,0000,0000,,I could fail out of medical school.
Dialogue: 0,0:04:42.44,0:04:46.35,Default,,0000,0000,0000,,But then I remembered, that wouldn't be\Nthe worst thing that happened to me
Dialogue: 0,0:04:46.35,0:04:47.48,Default,,0000,0000,0000,,even that year.
Dialogue: 0,0:04:47.48,0:04:51.22,Default,,0000,0000,0000,,So why not get started?
Dialogue: 0,0:04:51.22,0:04:53.12,Default,,0000,0000,0000,,Why not continue living\Nthe way that I wanted to live?
Dialogue: 0,0:04:53.12,0:04:56.56,Default,,0000,0000,0000,,So I did.
Dialogue: 0,0:04:56.56,0:04:58.58,Default,,0000,0000,0000,,Bald and rail thin,
Dialogue: 0,0:04:58.58,0:05:02.20,Default,,0000,0000,0000,,I put on my best earrings\Nand my favorite dress,
Dialogue: 0,0:05:02.20,0:05:04.84,Default,,0000,0000,0000,,and I started.
Dialogue: 0,0:05:04.84,0:05:06.09,Default,,0000,0000,0000,,I pretended to belong,
Dialogue: 0,0:05:06.09,0:05:08.21,Default,,0000,0000,0000,,and I began to.
Dialogue: 0,0:05:08.21,0:05:12.02,Default,,0000,0000,0000,,There is no way to describe\Nhow hard it was.
Dialogue: 0,0:05:12.02,0:05:13.88,Default,,0000,0000,0000,,Some days it felt impossible.
Dialogue: 0,0:05:13.88,0:05:18.44,Default,,0000,0000,0000,,It felt as I was doing things\Nthat would never matter in the future.
Dialogue: 0,0:05:18.44,0:05:21.98,Default,,0000,0000,0000,,But every day, I asked myself,\Nare you still enjoying this?
Dialogue: 0,0:05:21.98,0:05:24.82,Default,,0000,0000,0000,,Is this still what you want to be doing?
Dialogue: 0,0:05:24.82,0:05:26.98,Default,,0000,0000,0000,,And every day, the answer was yes,
Dialogue: 0,0:05:26.98,0:05:29.85,Default,,0000,0000,0000,,sometimes a very qualified yes,
Dialogue: 0,0:05:29.85,0:05:31.56,Default,,0000,0000,0000,,but a yes.
Dialogue: 0,0:05:31.56,0:05:33.84,Default,,0000,0000,0000,,And then, just as I\Nwas getting comfortable
Dialogue: 0,0:05:33.84,0:05:37.36,Default,,0000,0000,0000,,and feeling like I might not necessarily\Nfail out of medical school,
Dialogue: 0,0:05:37.36,0:05:40.56,Default,,0000,0000,0000,,I received even more devastating news.
Dialogue: 0,0:05:40.56,0:05:47.16,Default,,0000,0000,0000,,I learned that I had a mutation\Nin a gene called TP53, or p53 for short.
Dialogue: 0,0:05:47.16,0:05:50.45,Default,,0000,0000,0000,,Known as the guardian of the genome,
Dialogue: 0,0:05:50.45,0:05:56.49,Default,,0000,0000,0000,,a mutation, p53 is responsible\Nfor supervising the repair of our DNA.
Dialogue: 0,0:05:56.49,0:05:59.64,Default,,0000,0000,0000,,A mutation in this gene\Nmeans errors go uncorrected.
Dialogue: 0,0:05:59.64,0:06:03.62,Default,,0000,0000,0000,,It means that normal cells\Nbecome cancerous at a much higher rate.
Dialogue: 0,0:06:04.74,0:06:07.24,Default,,0000,0000,0000,,All of a sudden, with this knowledge,
Dialogue: 0,0:06:07.24,0:06:10.19,Default,,0000,0000,0000,,my medical history\Nmade a terrible kind of sense.
Dialogue: 0,0:06:10.19,0:06:13.79,Default,,0000,0000,0000,,I had had a childhood cancer --\Nrhabdomyosarcoma -- at age seven.
Dialogue: 0,0:06:13.79,0:06:16.76,Default,,0000,0000,0000,,It recurred when I was a teenager.
Dialogue: 0,0:06:16.76,0:06:20.63,Default,,0000,0000,0000,,And this was all before p53\Nhad been discovered in the lab.
Dialogue: 0,0:06:20.63,0:06:24.64,Default,,0000,0000,0000,,Then I'd had young adult\Nbreast and lung cancers.
Dialogue: 0,0:06:24.64,0:06:26.99,Default,,0000,0000,0000,,With the knowledge of this mutation,
Dialogue: 0,0:06:26.99,0:06:30.49,Default,,0000,0000,0000,,it seemed that there was likely\Nno end to the number of cancers
Dialogue: 0,0:06:30.49,0:06:32.73,Default,,0000,0000,0000,,that I could expect in my future.
Dialogue: 0,0:06:32.95,0:06:35.35,Default,,0000,0000,0000,,And yet,
Dialogue: 0,0:06:35.35,0:06:39.27,Default,,0000,0000,0000,,I decided to become\Na radiation oncologist.
Dialogue: 0,0:06:39.27,0:06:40.31,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:06:40.31,0:06:44.19,Default,,0000,0000,0000,,I hoped to graduate from residency\Nin just a few months,
Dialogue: 0,0:06:44.19,0:06:46.62,Default,,0000,0000,0000,,move to a new city,
Dialogue: 0,0:06:46.62,0:06:48.24,Default,,0000,0000,0000,,and start my first real job
Dialogue: 0,0:06:48.24,0:06:51.88,Default,,0000,0000,0000,,as a doctor and researcher,
Dialogue: 0,0:06:51.88,0:06:54.22,Default,,0000,0000,0000,,because of grit,
Dialogue: 0,0:06:54.22,0:06:55.70,Default,,0000,0000,0000,,because of privilege,
Dialogue: 0,0:06:55.70,0:06:57.57,Default,,0000,0000,0000,,because of therapy,
Dialogue: 0,0:06:57.57,0:07:01.73,Default,,0000,0000,0000,,because of my medical teams\Nand my family and my teachers,
Dialogue: 0,0:07:02.68,0:07:08.69,Default,,0000,0000,0000,,because genetic diagnoses
Dialogue: 0,0:07:08.69,0:07:09.48,Default,,0000,0000,0000,,should give us the knowledge\Nto move forward.
Dialogue: 0,0:07:09.48,0:07:12.41,Default,,0000,0000,0000,,And even in the year 2020,
Dialogue: 0,0:07:12.41,0:07:15.57,Default,,0000,0000,0000,,that generally doesn't mean\Nmiracle cures or medical breakthroughs.
Dialogue: 0,0:07:15.57,0:07:20.07,Default,,0000,0000,0000,,Having a devastating genetic diagnosis
Dialogue: 0,0:07:20.07,0:07:23.96,Default,,0000,0000,0000,,means learning to live with uncertainty.
Dialogue: 0,0:07:23.96,0:07:27.94,Default,,0000,0000,0000,,It means learning that you,\Nand your diagnosis,
Dialogue: 0,0:07:27.94,0:07:30.78,Default,,0000,0000,0000,,are not the worst thing that could happen.
Dialogue: 0,0:07:30.78,0:07:32.98,Default,,0000,0000,0000,,Learning to live with uncertainty
Dialogue: 0,0:07:32.98,0:07:35.60,Default,,0000,0000,0000,,means walking forward into a life
Dialogue: 0,0:07:35.60,0:07:39.77,Default,,0000,0000,0000,,that is as full of beauty\Nas it is of challenges.
Dialogue: 0,0:07:40.17,0:07:45.20,Default,,0000,0000,0000,,It means learning for yourself\Nthat cancer is just part of your story.
Dialogue: 0,0:07:45.20,0:07:47.74,Default,,0000,0000,0000,,It may not be the worst thing\Nthat happens to you,
Dialogue: 0,0:07:47.74,0:07:49.59,Default,,0000,0000,0000,,and if it is, that's OK.
Dialogue: 0,0:07:49.59,0:07:52.13,Default,,0000,0000,0000,,You can claim that, and you can own that,
Dialogue: 0,0:07:52.13,0:07:55.01,Default,,0000,0000,0000,,but let that be a narrative\Nthat you author and you authorize,
Dialogue: 0,0:07:55.01,0:07:59.11,Default,,0000,0000,0000,,not one that's prescribed to you\Nby someone else.
Dialogue: 0,0:07:59.11,0:08:01.28,Default,,0000,0000,0000,,Have your deferral letter in hand,\Nbut use it on your terms.
Dialogue: 0,0:08:01.28,0:08:04.27,Default,,0000,0000,0000,,As I come to the end\Nof my oncology training,
Dialogue: 0,0:08:04.27,0:08:07.89,Default,,0000,0000,0000,,I have deja vu again and again\Nwith the following scenario.
Dialogue: 0,0:08:07.89,0:08:12.20,Default,,0000,0000,0000,,A patient has cancer.
Dialogue: 0,0:08:12.20,0:08:14.16,Default,,0000,0000,0000,,There are several options,
Dialogue: 0,0:08:14.16,0:08:20.53,Default,,0000,0000,0000,,all of which offer a different balance\Nbetween cure and quality of life,
Dialogue: 0,0:08:20.53,0:08:24.43,Default,,0000,0000,0000,,between the possibility\Nof alleviating suffering
Dialogue: 0,0:08:24.43,0:08:29.52,Default,,0000,0000,0000,,and the possibility of causing suffering.
Dialogue: 0,0:08:29.52,0:08:31.07,Default,,0000,0000,0000,,An oncologist lays out the options,
Dialogue: 0,0:08:31.07,0:08:33.06,Default,,0000,0000,0000,,but, somewhere in the discussion,\Nthings get skewed.
Dialogue: 0,0:08:33.06,0:08:35.33,Default,,0000,0000,0000,,The choice becomes something more like,
Dialogue: 0,0:08:35.33,0:08:38.31,Default,,0000,0000,0000,,well, you could choose to do something
Dialogue: 0,0:08:38.31,0:08:41.52,Default,,0000,0000,0000,,or you could choose to do nothing.
Dialogue: 0,0:08:41.52,0:08:43.96,Default,,0000,0000,0000,,We could be aggressive
Dialogue: 0,0:08:43.96,0:08:45.99,Default,,0000,0000,0000,,and treat your cancer,
Dialogue: 0,0:08:45.99,0:08:48.03,Default,,0000,0000,0000,,or we could watch it,
Dialogue: 0,0:08:48.03,0:08:51.70,Default,,0000,0000,0000,,and 9.9 times out of 10, the patient says,
Dialogue: 0,0:08:51.70,0:08:54.72,Default,,0000,0000,0000,,"I want to do everything I can do."
Dialogue: 0,0:08:54.94,0:08:56.66,Default,,0000,0000,0000,,Of course.
Dialogue: 0,0:08:56.66,0:08:59.93,Default,,0000,0000,0000,,Who wouldn't want everything?
Dialogue: 0,0:09:00.28,0:09:02.92,Default,,0000,0000,0000,,But what is everything?
Dialogue: 0,0:09:02.92,0:09:08.73,Default,,0000,0000,0000,,Is everything the ability to sit\Nin your own home in front of your window
Dialogue: 0,0:09:08.73,0:09:11.82,Default,,0000,0000,0000,,bathed in sunshine\Nand surrounded by family?
Dialogue: 0,0:09:12.04,0:09:16.81,Default,,0000,0000,0000,,Is everything still being able\Nto feel your fingers and your toes
Dialogue: 0,0:09:16.81,0:09:20.02,Default,,0000,0000,0000,,because they haven't gone numb\Nfrom chemotherapy.
Dialogue: 0,0:09:20.02,0:09:22.39,Default,,0000,0000,0000,,As oncologists, our everything\Nis cancer treatment.
Dialogue: 0,0:09:22.39,0:09:30.04,Default,,0000,0000,0000,,It's radiation and surgery\Nand chemotherapy and novel treatments.
Dialogue: 0,0:09:30.04,0:09:33.32,Default,,0000,0000,0000,,And for us, the worst thing\Nthat could happen,
Dialogue: 0,0:09:33.32,0:09:35.83,Default,,0000,0000,0000,,and I have heard more than one\Noncologist say this,
Dialogue: 0,0:09:35.83,0:09:38.24,Default,,0000,0000,0000,,the worst thing that could happen\Nis that the patient will develop
Dialogue: 0,0:09:38.24,0:09:39.90,Default,,0000,0000,0000,,metastatic disease.
Dialogue: 0,0:09:39.90,0:09:43.72,Default,,0000,0000,0000,,Or, the worst thing that could happen\Nis that five years from now,
Dialogue: 0,0:09:43.72,0:09:47.29,Default,,0000,0000,0000,,the cancer will grow and I'll\Nhave to give more radiation.
Dialogue: 0,0:09:47.29,0:09:49.94,Default,,0000,0000,0000,,As a patient and as an oncologist,
Dialogue: 0,0:09:49.94,0:09:54.07,Default,,0000,0000,0000,,I would never argue that these\Nare not devastating outcomes.
Dialogue: 0,0:09:54.07,0:09:56.12,Default,,0000,0000,0000,,But are they the worst?
Dialogue: 0,0:09:56.12,0:09:58.49,Default,,0000,0000,0000,,Should cancer control,
Dialogue: 0,0:09:58.49,0:10:03.77,Default,,0000,0000,0000,,be at the center, of our thinking always?
Dialogue: 0,0:10:03.77,0:10:11.04,Default,,0000,0000,0000,,Many unspeakably, unfathomably painful\Nand brutal things have happened to me
Dialogue: 0,0:10:11.04,0:10:15.00,Default,,0000,0000,0000,,because of my cancers\Nand my genetic mutation.
Dialogue: 0,0:10:15.00,0:10:19.33,Default,,0000,0000,0000,,And yet, I consider myself\Nvery lucky indeed,
Dialogue: 0,0:10:19.33,0:10:23.24,Default,,0000,0000,0000,,because the worst thing\Nthat could happen never came to pass,
Dialogue: 0,0:10:23.24,0:10:28.47,Default,,0000,0000,0000,,because I have let devastation\Nand uncertainty sit at the table,
Dialogue: 0,0:10:28.47,0:10:30.90,Default,,0000,0000,0000,,but somewhere off to the side.
Dialogue: 0,0:10:30.90,0:10:33.62,Default,,0000,0000,0000,,When I was diagnosed\Nwith metastatic breast cancer,
Dialogue: 0,0:10:33.62,0:10:37.72,Default,,0000,0000,0000,,I went to Boston for a second opinion,\Nbecause what could I lose?
Dialogue: 0,0:10:37.72,0:10:40.72,Default,,0000,0000,0000,,When my oncologist gave me\Nvery good and very safe
Dialogue: 0,0:10:40.72,0:10:42.50,Default,,0000,0000,0000,,and very standard advice,
Dialogue: 0,0:10:42.50,0:10:44.40,Default,,0000,0000,0000,,I started medical school anyway,
Dialogue: 0,0:10:44.40,0:10:48.07,Default,,0000,0000,0000,,even though I was undergoing\Nactive cancer treatment.
Dialogue: 0,0:10:48.32,0:10:51.93,Default,,0000,0000,0000,,Instead of shying away\Nfrom patients with cancer,
Dialogue: 0,0:10:51.93,0:10:54.07,Default,,0000,0000,0000,,I became a radiation oncologist,
Dialogue: 0,0:10:54.07,0:10:57.30,Default,,0000,0000,0000,,and I work with patients\Nwho are very much like me
Dialogue: 0,0:10:57.30,0:10:58.56,Default,,0000,0000,0000,,every single day.
Dialogue: 0,0:10:58.56,0:11:03.73,Default,,0000,0000,0000,,Instead of imagining the suffering\Nthat I might cause to a future partner
Dialogue: 0,0:11:03.73,0:11:05.82,Default,,0000,0000,0000,,when I died of cancer,
Dialogue: 0,0:11:05.82,0:11:09.24,Default,,0000,0000,0000,,I married my wonderful husband.
Dialogue: 0,0:11:09.45,0:11:13.45,Default,,0000,0000,0000,,Because, the worst thing that can happen
Dialogue: 0,0:11:13.45,0:11:15.02,Default,,0000,0000,0000,,is always a series of negatives.
Dialogue: 0,0:11:15.02,0:11:17.47,Default,,0000,0000,0000,,It's blank spaces
Dialogue: 0,0:11:17.47,0:11:19.88,Default,,0000,0000,0000,,that should be filled with life.
Dialogue: 0,0:11:20.61,0:11:27.34,Default,,0000,0000,0000,,So what is the most that I have leaned in\Nto this kind of radical uncertainty?
Dialogue: 0,0:11:27.92,0:11:31.06,Default,,0000,0000,0000,,Well, this is William.
Dialogue: 0,0:11:32.26,0:11:37.62,Default,,0000,0000,0000,,He is the most joyful person\Nthat I have ever met,
Dialogue: 0,0:11:38.80,0:11:44.46,Default,,0000,0000,0000,,and in just over a year, he has already\Nmade the world a better place.
Dialogue: 0,0:11:45.45,0:11:50.52,Default,,0000,0000,0000,,As oncologists, we talk to our patients
Dialogue: 0,0:11:50.52,0:11:52.43,Default,,0000,0000,0000,,as if the worst thing that could happen
Dialogue: 0,0:11:52.43,0:11:54.68,Default,,0000,0000,0000,,is that their cancer could come back,
Dialogue: 0,0:11:54.68,0:11:57.87,Default,,0000,0000,0000,,or that it could spread,\Nor that they could die from it.
Dialogue: 0,0:11:58.30,0:12:01.86,Default,,0000,0000,0000,,As a patient, I know\Nthat these are paramount,
Dialogue: 0,0:12:01.86,0:12:04.25,Default,,0000,0000,0000,,but I want to change the way\Nthat we think about this,
Dialogue: 0,0:12:04.25,0:12:08.38,Default,,0000,0000,0000,,and I want to change the way\Nthat we talk about this with our patients.
Dialogue: 0,0:12:08.55,0:12:09.92,Default,,0000,0000,0000,,As a patient,
Dialogue: 0,0:12:09.92,0:12:14.68,Default,,0000,0000,0000,,the worst thing that can happen\Nis that cancer robs you of opportunity,
Dialogue: 0,0:12:14.68,0:12:17.23,Default,,0000,0000,0000,,of the ability to be and to do
Dialogue: 0,0:12:17.23,0:12:19.35,Default,,0000,0000,0000,,and to love.
Dialogue: 0,0:12:20.29,0:12:21.72,Default,,0000,0000,0000,,And it will.
Dialogue: 0,0:12:21.72,0:12:25.11,Default,,0000,0000,0000,,At least, temporarily, it will.
Dialogue: 0,0:12:25.11,0:12:28.36,Default,,0000,0000,0000,,But to minimize this loss\Nof life in the living,
Dialogue: 0,0:12:28.36,0:12:31.51,Default,,0000,0000,0000,,that is the harder
Dialogue: 0,0:12:31.51,0:12:34.71,Default,,0000,0000,0000,,and I would say truer job\Nof the oncologist:
Dialogue: 0,0:12:34.71,0:12:39.10,Default,,0000,0000,0000,,to take all the tools that we have\Nand situate them in the context
Dialogue: 0,0:12:39.10,0:12:41.78,Default,,0000,0000,0000,,of a patient's whole entire life;
Dialogue: 0,0:12:41.78,0:12:45.88,Default,,0000,0000,0000,,to be guides for how\Nto sit with suffering,
Dialogue: 0,0:12:45.88,0:12:47.100,Default,,0000,0000,0000,,acknowledge it deeply,
Dialogue: 0,0:12:47.100,0:12:54.28,Default,,0000,0000,0000,,but to not let fear of future suffering\Nbe the narrative for the journey forward.
Dialogue: 0,0:12:54.28,0:12:56.41,Default,,0000,0000,0000,,One of my mentors always says,
Dialogue: 0,0:12:56.41,0:13:00.02,Default,,0000,0000,0000,,the medicine part is easy,
Dialogue: 0,0:13:00.02,0:13:03.27,Default,,0000,0000,0000,,and it never feels that way\Nto a junior doctor,
Dialogue: 0,0:13:03.27,0:13:06.86,Default,,0000,0000,0000,,but it's contours are finite.
Dialogue: 0,0:13:06.86,0:13:13.74,Default,,0000,0000,0000,,We have big studies to guide us,\Nand it's what we learn to do in residency.
Dialogue: 0,0:13:13.74,0:13:21.03,Default,,0000,0000,0000,,Much harder is learning how to help\Neach patient navigate the multitudes
Dialogue: 0,0:13:21.03,0:13:24.18,Default,,0000,0000,0000,,contained in their illness.
Dialogue: 0,0:13:24.79,0:13:28.70,Default,,0000,0000,0000,,So I find it really funny
Dialogue: 0,0:13:28.70,0:13:33.03,Default,,0000,0000,0000,,that, in retrospect, my life\Nlooks like a neat package.
Dialogue: 0,0:13:33.03,0:13:37.43,Default,,0000,0000,0000,,It looks as if I planned\Neach successive step,
Dialogue: 0,0:13:37.43,0:13:42.17,Default,,0000,0000,0000,,and that perhaps cancer\Nhas led to the good things in my life.
Dialogue: 0,0:13:42.46,0:13:45.91,Default,,0000,0000,0000,,Step one: apply to medical school.
Dialogue: 0,0:13:45.91,0:13:49.50,Default,,0000,0000,0000,,Step two: get diagnosed with\Nand treated for cancer.
Dialogue: 0,0:13:49.50,0:13:52.12,Default,,0000,0000,0000,,And step three: have it all,
Dialogue: 0,0:13:52.12,0:13:56.58,Default,,0000,0000,0000,,a career and a family.
Dialogue: 0,0:13:56.58,0:13:58.39,Default,,0000,0000,0000,,But I will tell you
Dialogue: 0,0:13:58.39,0:14:02.89,Default,,0000,0000,0000,,that each phase was a leap of faith
Dialogue: 0,0:14:02.89,0:14:08.48,Default,,0000,0000,0000,,despite an almost paralyzing uncertainty.
Dialogue: 0,0:14:08.48,0:14:10.06,Default,,0000,0000,0000,,And so it's that courage
Dialogue: 0,0:14:10.06,0:14:13.44,Default,,0000,0000,0000,,that I try to give to each of my patients.
Dialogue: 0,0:14:13.62,0:14:17.86,Default,,0000,0000,0000,,I try to do this regardless\Nof the technical medical details
Dialogue: 0,0:14:17.86,0:14:21.03,Default,,0000,0000,0000,,of cancers and treatment decisions
Dialogue: 0,0:14:21.03,0:14:22.07,Default,,0000,0000,0000,,and mutations,
Dialogue: 0,0:14:22.07,0:14:25.56,Default,,0000,0000,0000,,regardless of the slippery fiction
Dialogue: 0,0:14:25.56,0:14:26.76,Default,,0000,0000,0000,,of prognosis.
Dialogue: 0,0:14:26.76,0:14:29.66,Default,,0000,0000,0000,,I try to learn what they want
Dialogue: 0,0:14:29.66,0:14:31.62,Default,,0000,0000,0000,,and what they need,
Dialogue: 0,0:14:31.62,0:14:35.04,Default,,0000,0000,0000,,what they wish and what they worry,
Dialogue: 0,0:14:36.44,0:14:39.86,Default,,0000,0000,0000,,what they dream about,
Dialogue: 0,0:14:39.86,0:14:42.74,Default,,0000,0000,0000,,what animated them before
Dialogue: 0,0:14:43.49,0:14:49.76,Default,,0000,0000,0000,,and what will sustain them during\Nthe beastly process of cancer treatment.
Dialogue: 0,0:14:51.33,0:14:54.57,Default,,0000,0000,0000,,It doesn't actually take that much time.
Dialogue: 0,0:14:55.54,0:15:00.68,Default,,0000,0000,0000,,It does take a few focused, quiet moments
Dialogue: 0,0:15:00.68,0:15:03.80,Default,,0000,0000,0000,,that require intentional cultivation.
Dialogue: 0,0:15:04.96,0:15:08.41,Default,,0000,0000,0000,,But this is partnership,
Dialogue: 0,0:15:08.41,0:15:10.91,Default,,0000,0000,0000,,and it matters,
Dialogue: 0,0:15:11.74,0:15:14.54,Default,,0000,0000,0000,,because the worst thing that can happen
Dialogue: 0,0:15:14.54,0:15:19.36,Default,,0000,0000,0000,,is to have an oncologist\Nwho does everything,
Dialogue: 0,0:15:19.36,0:15:24.10,Default,,0000,0000,0000,,everything to help cure your cancer
Dialogue: 0,0:15:24.10,0:15:29.02,Default,,0000,0000,0000,,and who does nothing\Nto help you live your life.
Dialogue: 0,0:15:29.68,0:15:31.93,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:15:31.93,0:15:35.94,Default,,0000,0000,0000,,(Applause)