[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.73,0:00:03.42,Default,,0000,0000,0000,,What's the worst that can happen?
Dialogue: 0,0:00:04.34,0:00:06.56,Default,,0000,0000,0000,,Almost exactly 10 years ago,
Dialogue: 0,0:00:06.58,0:00:10.31,Default,,0000,0000,0000,,I was sitting in an exam room\Nthat was way too cold
Dialogue: 0,0:00:10.33,0:00:12.83,Default,,0000,0000,0000,,waiting to meet my new oncologist.
Dialogue: 0,0:00:12.85,0:00:14.79,Default,,0000,0000,0000,,I was terrified.
Dialogue: 0,0:00:14.81,0:00:18.79,Default,,0000,0000,0000,,Even though my partner at the time\Nwas sitting right by my side,
Dialogue: 0,0:00:18.81,0:00:20.79,Default,,0000,0000,0000,,I felt completely alone.
Dialogue: 0,0:00:21.30,0:00:24.28,Default,,0000,0000,0000,,I had just been diagnosed\Nwith breast cancer,
Dialogue: 0,0:00:24.31,0:00:25.93,Default,,0000,0000,0000,,and it seemed at the time
Dialogue: 0,0:00:25.96,0:00:30.13,Default,,0000,0000,0000,,that a single bright spot\Non a scan of my right lung
Dialogue: 0,0:00:30.16,0:00:33.09,Default,,0000,0000,0000,,meant that the cancer had already spread.
Dialogue: 0,0:00:33.72,0:00:36.12,Default,,0000,0000,0000,,I had metastatic breast cancer.
Dialogue: 0,0:00:36.70,0:00:39.17,Default,,0000,0000,0000,,I had no medical training at this point,
Dialogue: 0,0:00:39.19,0:00:41.28,Default,,0000,0000,0000,,but I knew what it meant if it were true:
Dialogue: 0,0:00:42.08,0:00:44.36,Default,,0000,0000,0000,,incurable breast cancer.
Dialogue: 0,0:00:45.74,0:00:48.26,Default,,0000,0000,0000,,Terminal breast cancer.
Dialogue: 0,0:00:48.99,0:00:51.39,Default,,0000,0000,0000,,I was 27 years old,
Dialogue: 0,0:00:51.41,0:00:54.08,Default,,0000,0000,0000,,had just been accepted to medical school,
Dialogue: 0,0:00:54.10,0:00:57.36,Default,,0000,0000,0000,,and I wondered if I was already\Nat the end of my life.
Dialogue: 0,0:00:58.44,0:01:03.01,Default,,0000,0000,0000,,My new oncologist was not a warm person.
Dialogue: 0,0:01:04.12,0:01:06.37,Default,,0000,0000,0000,,She dealt in simple facts,
Dialogue: 0,0:01:06.40,0:01:08.77,Default,,0000,0000,0000,,as many brilliant physicians do.
Dialogue: 0,0:01:09.75,0:01:13.62,Default,,0000,0000,0000,,"Our body is made up\Nof cells," she started.
Dialogue: 0,0:01:14.36,0:01:15.94,Default,,0000,0000,0000,,I stopped her.
Dialogue: 0,0:01:16.38,0:01:18.57,Default,,0000,0000,0000,,"I'm starting medical school soon.
Dialogue: 0,0:01:18.60,0:01:19.83,Default,,0000,0000,0000,,I know."
Dialogue: 0,0:01:20.80,0:01:25.49,Default,,0000,0000,0000,,Instead of taking this as a signal\Nto go backward, to start again,
Dialogue: 0,0:01:25.52,0:01:27.23,Default,,0000,0000,0000,,she went forward.
Dialogue: 0,0:01:27.25,0:01:29.70,Default,,0000,0000,0000,,She said that I would need\Nto start on chemotherapy
Dialogue: 0,0:01:29.73,0:01:31.19,Default,,0000,0000,0000,,to control the cancer.
Dialogue: 0,0:01:31.21,0:01:34.74,Default,,0000,0000,0000,,She launched into the details\Nof the drug and the side effects
Dialogue: 0,0:01:34.77,0:01:35.96,Default,,0000,0000,0000,,and the schedule.
Dialogue: 0,0:01:36.54,0:01:40.50,Default,,0000,0000,0000,,I reminded her that we hadn't even yet\Nbiopsied the bright spot on my lung,
Dialogue: 0,0:01:40.53,0:01:44.47,Default,,0000,0000,0000,,and I asked if she was sure\Nthat it was cancer.
Dialogue: 0,0:01:45.28,0:01:50.75,Default,,0000,0000,0000,,I remember viscerally how she seemed\Nalmost frustrated with my question.
Dialogue: 0,0:01:50.77,0:01:54.27,Default,,0000,0000,0000,,Perhaps she thought I wasn't\Nfollowing along with her explanations,
Dialogue: 0,0:01:54.29,0:01:56.85,Default,,0000,0000,0000,,or, worse still, I was in denial.
Dialogue: 0,0:01:57.94,0:02:01.37,Default,,0000,0000,0000,,I simply wanted her to understand\Nthat, as her patient,
Dialogue: 0,0:02:01.40,0:02:06.73,Default,,0000,0000,0000,,the biopsy was not just a mere formality\Nto prove an already foregone conclusion.
Dialogue: 0,0:02:06.75,0:02:11.06,Default,,0000,0000,0000,,It was a steel needle\Nthrough skin, muscle and bone
Dialogue: 0,0:02:11.08,0:02:15.35,Default,,0000,0000,0000,,that would deliver a deep piece of me\Nto the surface and answer a question
Dialogue: 0,0:02:15.38,0:02:18.25,Default,,0000,0000,0000,,I wish didn't have to be asked.
Dialogue: 0,0:02:18.28,0:02:22.54,Default,,0000,0000,0000,,Before the biopsy, I could be\Na 27-year-old woman
Dialogue: 0,0:02:22.56,0:02:25.58,Default,,0000,0000,0000,,who might have metastatic breast cancer,
Dialogue: 0,0:02:25.60,0:02:29.02,Default,,0000,0000,0000,,who probably had metastatic breast cancer.
Dialogue: 0,0:02:29.05,0:02:31.43,Default,,0000,0000,0000,,This is a critical distinction,
Dialogue: 0,0:02:31.45,0:02:35.92,Default,,0000,0000,0000,,but it's not one that's emphasized\Nin the most elite oncology training.
Dialogue: 0,0:02:36.77,0:02:40.77,Default,,0000,0000,0000,,Instead, I was dismissed\Nwith an appointment to start treatment
Dialogue: 0,0:02:40.80,0:02:42.49,Default,,0000,0000,0000,,in just a few weeks.
Dialogue: 0,0:02:43.53,0:02:47.18,Default,,0000,0000,0000,,So much has happened\Nsince that first visit.
Dialogue: 0,0:02:47.21,0:02:50.46,Default,,0000,0000,0000,,Ironically, the biopsy was not\Njust a mere formality.
Dialogue: 0,0:02:50.48,0:02:53.51,Default,,0000,0000,0000,,My former oncologist was right.
Dialogue: 0,0:02:53.54,0:02:54.66,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:02:54.68,0:02:56.27,Default,,0000,0000,0000,,It did show cancer,
Dialogue: 0,0:02:56.30,0:03:00.24,Default,,0000,0000,0000,,but it was a totally separate lung cancer,
Dialogue: 0,0:03:00.26,0:03:02.26,Default,,0000,0000,0000,,and as crazy as it sounds,
Dialogue: 0,0:03:02.28,0:03:04.100,Default,,0000,0000,0000,,this was great news.
Dialogue: 0,0:03:05.02,0:03:07.60,Default,,0000,0000,0000,,I did not have metastatic breast cancer,
Dialogue: 0,0:03:07.62,0:03:09.91,Default,,0000,0000,0000,,I had two different cancers,
Dialogue: 0,0:03:09.93,0:03:12.38,Default,,0000,0000,0000,,but both of them were localized,
Dialogue: 0,0:03:12.40,0:03:14.66,Default,,0000,0000,0000,,and so the lung cancer\Nwas localized enough
Dialogue: 0,0:03:14.68,0:03:16.56,Default,,0000,0000,0000,,that it could be removed.
Dialogue: 0,0:03:16.59,0:03:20.26,Default,,0000,0000,0000,,And so the onslaught of treatments began\Nwith a lung surgery,
Dialogue: 0,0:03:20.28,0:03:21.100,Default,,0000,0000,0000,,continued with chemotherapy
Dialogue: 0,0:03:22.02,0:03:26.23,Default,,0000,0000,0000,,and ended with a breast surgery\Njust after my 28th birthday.
Dialogue: 0,0:03:26.92,0:03:28.62,Default,,0000,0000,0000,,And then two weeks later,
Dialogue: 0,0:03:29.30,0:03:31.36,Default,,0000,0000,0000,,I started medical school.
Dialogue: 0,0:03:32.36,0:03:34.68,Default,,0000,0000,0000,,My new oncologist --
Dialogue: 0,0:03:34.70,0:03:35.73,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:03:35.76,0:03:40.63,Default,,0000,0000,0000,,who deals much more fluidly\Nboth with facts and their implications,
Dialogue: 0,0:03:40.65,0:03:42.14,Default,,0000,0000,0000,,very reasonably suggested
Dialogue: 0,0:03:42.16,0:03:46.20,Default,,0000,0000,0000,,that I should defer my acceptance\Nto medical school for a year,
Dialogue: 0,0:03:46.22,0:03:49.95,Default,,0000,0000,0000,,take some time to rest, to recover,
Dialogue: 0,0:03:49.98,0:03:51.79,Default,,0000,0000,0000,,and I trusted her advice.
Dialogue: 0,0:03:51.82,0:03:56.44,Default,,0000,0000,0000,,I felt terrible during the intensive\Nchemotherapy sessions.
Dialogue: 0,0:03:56.47,0:03:58.08,Default,,0000,0000,0000,,And so I wrote to the dean.
Dialogue: 0,0:03:58.10,0:04:00.12,Default,,0000,0000,0000,,I explained my circumstances,
Dialogue: 0,0:04:00.15,0:04:02.65,Default,,0000,0000,0000,,and a deferral was speedily granted.
Dialogue: 0,0:04:03.46,0:04:05.94,Default,,0000,0000,0000,,But as the chemo fog lifted,
Dialogue: 0,0:04:05.97,0:04:09.23,Default,,0000,0000,0000,,I wondered what\NI was going to do with a year.
Dialogue: 0,0:04:09.80,0:04:12.20,Default,,0000,0000,0000,,Should I go to the beach?
Dialogue: 0,0:04:12.22,0:04:13.26,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:04:13.28,0:04:15.70,Default,,0000,0000,0000,,I wasn't really a beach person.
Dialogue: 0,0:04:15.73,0:04:16.81,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:04:16.83,0:04:20.85,Default,,0000,0000,0000,,And how many years\Ndid I have left, anyway?
Dialogue: 0,0:04:20.88,0:04:23.03,Default,,0000,0000,0000,,I really wanted to go to medical school.
Dialogue: 0,0:04:23.05,0:04:25.87,Default,,0000,0000,0000,,It seemed like\Na missing piece of my puzzle.
Dialogue: 0,0:04:26.47,0:04:30.02,Default,,0000,0000,0000,,So instead of going around\Nand around with indecision,
Dialogue: 0,0:04:30.04,0:04:33.04,Default,,0000,0000,0000,,I asked myself: What's the worst\Nthat could happen?
Dialogue: 0,0:04:33.07,0:04:36.88,Default,,0000,0000,0000,,Well, I could be too weak\Nor too sick to do the work.
Dialogue: 0,0:04:36.91,0:04:39.33,Default,,0000,0000,0000,,It could be too hard for me emotionally.
Dialogue: 0,0:04:39.35,0:04:42.28,Default,,0000,0000,0000,,I could fail out of medical school.
Dialogue: 0,0:04:42.30,0:04:45.90,Default,,0000,0000,0000,,But then I remembered, that wouldn't be\Nthe worst thing that happened to me
Dialogue: 0,0:04:45.92,0:04:47.34,Default,,0000,0000,0000,,even that year.
Dialogue: 0,0:04:47.36,0:04:50.14,Default,,0000,0000,0000,,So why not get started?
Dialogue: 0,0:04:50.17,0:04:54.12,Default,,0000,0000,0000,,Why not continue living\Nthe way that I wanted to live?
Dialogue: 0,0:04:54.67,0:04:56.22,Default,,0000,0000,0000,,So I did.
Dialogue: 0,0:04:56.24,0:04:58.22,Default,,0000,0000,0000,,Bald and rail thin,
Dialogue: 0,0:04:58.24,0:05:01.89,Default,,0000,0000,0000,,I put on my best earrings\Nand my favorite dress,
Dialogue: 0,0:05:01.92,0:05:03.62,Default,,0000,0000,0000,,and I started.
Dialogue: 0,0:05:03.65,0:05:05.81,Default,,0000,0000,0000,,I pretended to belong,
Dialogue: 0,0:05:05.83,0:05:07.29,Default,,0000,0000,0000,,and I began to.
Dialogue: 0,0:05:07.92,0:05:11.03,Default,,0000,0000,0000,,There is no way to describe\Nhow hard it was.
Dialogue: 0,0:05:11.05,0:05:13.51,Default,,0000,0000,0000,,Some days it felt impossible.
Dialogue: 0,0:05:13.53,0:05:17.79,Default,,0000,0000,0000,,It felt as I was doing things\Nthat would never matter in the future.
Dialogue: 0,0:05:18.31,0:05:21.78,Default,,0000,0000,0000,,But every day, I asked myself:\NAre you still enjoying this?
Dialogue: 0,0:05:21.80,0:05:23.96,Default,,0000,0000,0000,,Is this still what you want to be doing?
Dialogue: 0,0:05:24.45,0:05:26.65,Default,,0000,0000,0000,,And every day, the answer was yes,
Dialogue: 0,0:05:26.68,0:05:29.18,Default,,0000,0000,0000,,sometimes a very qualified yes,
Dialogue: 0,0:05:29.20,0:05:30.62,Default,,0000,0000,0000,,but a yes.
Dialogue: 0,0:05:31.08,0:05:33.46,Default,,0000,0000,0000,,And then, just as I was\Ngetting comfortable
Dialogue: 0,0:05:33.49,0:05:37.21,Default,,0000,0000,0000,,and feeling like I might not necessarily\Nfail out of medical school,
Dialogue: 0,0:05:37.23,0:05:40.38,Default,,0000,0000,0000,,I received even more devastating news.
Dialogue: 0,0:05:40.40,0:05:47.03,Default,,0000,0000,0000,,I learned that I had a mutation\Nin a gene called TP53, or p53 for short.
Dialogue: 0,0:05:47.06,0:05:49.62,Default,,0000,0000,0000,,Known as the guardian of the genome,
Dialogue: 0,0:05:49.64,0:05:50.93,Default,,0000,0000,0000,,a mutation,
Dialogue: 0,0:05:50.96,0:05:55.78,Default,,0000,0000,0000,,p53 is responsible for supervising\Nthe repair of our DNA.
Dialogue: 0,0:05:56.17,0:05:59.67,Default,,0000,0000,0000,,A mutation in this gene\Nmeans errors go uncorrected.
Dialogue: 0,0:05:59.69,0:06:03.60,Default,,0000,0000,0000,,It means that normal cells\Nbecome cancerous at a much higher rate.
Dialogue: 0,0:06:04.36,0:06:06.25,Default,,0000,0000,0000,,All of a sudden, with this knowledge,
Dialogue: 0,0:06:06.27,0:06:09.20,Default,,0000,0000,0000,,my medical history\Nmade a terrible kind of sense.
Dialogue: 0,0:06:09.54,0:06:14.04,Default,,0000,0000,0000,,I had had a childhood cancer --\Nrhabdomyosarcoma -- at age seven.
Dialogue: 0,0:06:14.07,0:06:16.07,Default,,0000,0000,0000,,It recurred when I was a teenager.
Dialogue: 0,0:06:16.10,0:06:19.71,Default,,0000,0000,0000,,And this was all before p53\Nhad been discovered in the lab.
Dialogue: 0,0:06:20.22,0:06:23.66,Default,,0000,0000,0000,,Then I'd had young adult\Nbreast and lung cancers.
Dialogue: 0,0:06:24.37,0:06:26.50,Default,,0000,0000,0000,,With the knowledge of this mutation,
Dialogue: 0,0:06:26.53,0:06:29.02,Default,,0000,0000,0000,,it seemed that there was likely no end
Dialogue: 0,0:06:29.05,0:06:32.16,Default,,0000,0000,0000,,to the number of cancers\Nthat I could expect in my future.
Dialogue: 0,0:06:33.41,0:06:34.75,Default,,0000,0000,0000,,And yet,
Dialogue: 0,0:06:34.77,0:06:38.75,Default,,0000,0000,0000,,I decided to become\Na radiation oncologist.
Dialogue: 0,0:06:38.78,0:06:39.84,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:06:39.86,0:06:43.88,Default,,0000,0000,0000,,I hoped to graduate from residency\Nin just a few months,
Dialogue: 0,0:06:43.91,0:06:45.38,Default,,0000,0000,0000,,move to a new city
Dialogue: 0,0:06:45.41,0:06:49.81,Default,,0000,0000,0000,,and start my first real job\Nas a doctor and researcher,
Dialogue: 0,0:06:50.88,0:06:53.26,Default,,0000,0000,0000,,because of grit,
Dialogue: 0,0:06:53.29,0:06:54.91,Default,,0000,0000,0000,,because of privilege,
Dialogue: 0,0:06:54.93,0:06:57.32,Default,,0000,0000,0000,,because of therapy,
Dialogue: 0,0:06:57.34,0:07:01.80,Default,,0000,0000,0000,,because of my medical teams\Nand my family and my teachers,
Dialogue: 0,0:07:02.60,0:07:06.70,Default,,0000,0000,0000,,because genetic diagnoses\Nshould give us the knowledge
Dialogue: 0,0:07:06.73,0:07:08.05,Default,,0000,0000,0000,,to move forward.
Dialogue: 0,0:07:08.68,0:07:11.70,Default,,0000,0000,0000,,And even in the year 2020,
Dialogue: 0,0:07:11.72,0:07:16.41,Default,,0000,0000,0000,,that generally doesn't mean\Nmiracle cures or medical breakthroughs.
Dialogue: 0,0:07:16.99,0:07:20.04,Default,,0000,0000,0000,,Having a devastating genetic diagnosis
Dialogue: 0,0:07:20.07,0:07:23.31,Default,,0000,0000,0000,,means learning to live with uncertainty.
Dialogue: 0,0:07:24.03,0:07:27.37,Default,,0000,0000,0000,,It means learning that you\Nand your diagnosis
Dialogue: 0,0:07:27.40,0:07:29.62,Default,,0000,0000,0000,,are not the worst thing that could happen.
Dialogue: 0,0:07:30.48,0:07:32.39,Default,,0000,0000,0000,,Learning to live with uncertainty
Dialogue: 0,0:07:32.42,0:07:34.79,Default,,0000,0000,0000,,means walking forward into a life
Dialogue: 0,0:07:34.82,0:07:39.33,Default,,0000,0000,0000,,that is as full of beauty\Nas it is of challenges.
Dialogue: 0,0:07:39.91,0:07:44.86,Default,,0000,0000,0000,,It means learning for yourself\Nthat cancer is just part of your story.
Dialogue: 0,0:07:44.88,0:07:47.39,Default,,0000,0000,0000,,It may not be the worst thing\Nthat happens to you,
Dialogue: 0,0:07:47.42,0:07:49.32,Default,,0000,0000,0000,,and if it is, that's OK.
Dialogue: 0,0:07:49.35,0:07:51.82,Default,,0000,0000,0000,,You can claim that, and you can own that,
Dialogue: 0,0:07:51.84,0:07:55.57,Default,,0000,0000,0000,,but let that be a narrative\Nthat you author and you authorize,
Dialogue: 0,0:07:55.60,0:07:58.63,Default,,0000,0000,0000,,not one that's prescribed to you\Nby someone else.
Dialogue: 0,0:07:58.66,0:08:02.90,Default,,0000,0000,0000,,Have your deferral letter in hand,\Nbut use it on your terms.
Dialogue: 0,0:08:04.35,0:08:07.08,Default,,0000,0000,0000,,As I come to the end\Nof my oncology training,
Dialogue: 0,0:08:07.10,0:08:10.54,Default,,0000,0000,0000,,I have déjà vu again and again\Nwith the following scenario:
Dialogue: 0,0:08:10.56,0:08:12.53,Default,,0000,0000,0000,,A patient has cancer.
Dialogue: 0,0:08:12.56,0:08:14.32,Default,,0000,0000,0000,,There are several options,
Dialogue: 0,0:08:14.34,0:08:20.29,Default,,0000,0000,0000,,all of which offer a different balance\Nbetween cure and quality of life,
Dialogue: 0,0:08:20.31,0:08:24.17,Default,,0000,0000,0000,,between the possibility\Nof alleviating suffering
Dialogue: 0,0:08:24.19,0:08:27.10,Default,,0000,0000,0000,,and the possibility of causing suffering.
Dialogue: 0,0:08:27.12,0:08:29.20,Default,,0000,0000,0000,,An oncologist lays out the options,
Dialogue: 0,0:08:29.23,0:08:32.54,Default,,0000,0000,0000,,but, somewhere in the discussion,\Nthings get skewed.
Dialogue: 0,0:08:32.56,0:08:34.61,Default,,0000,0000,0000,,The choice becomes something more like,
Dialogue: 0,0:08:34.64,0:08:37.96,Default,,0000,0000,0000,,"Well, you could choose to do something
Dialogue: 0,0:08:37.98,0:08:40.57,Default,,0000,0000,0000,,or you could choose to do nothing.
Dialogue: 0,0:08:41.39,0:08:45.74,Default,,0000,0000,0000,,We could be aggressive,\Nand treat your cancer,
Dialogue: 0,0:08:45.76,0:08:47.12,Default,,0000,0000,0000,,or we could watch it."
Dialogue: 0,0:08:47.84,0:08:50.41,Default,,0000,0000,0000,,And 9.9 times out of 10, the patient says,
Dialogue: 0,0:08:50.44,0:08:54.05,Default,,0000,0000,0000,,"I want to do everything I can do."
Dialogue: 0,0:08:54.66,0:08:56.35,Default,,0000,0000,0000,,Of course.
Dialogue: 0,0:08:56.37,0:08:59.74,Default,,0000,0000,0000,,Who wouldn't want everything?
Dialogue: 0,0:09:00.45,0:09:02.05,Default,,0000,0000,0000,,But what is everything?
Dialogue: 0,0:09:02.78,0:09:08.42,Default,,0000,0000,0000,,Is everything the ability to sit\Nin your own home in front of your window
Dialogue: 0,0:09:08.45,0:09:11.58,Default,,0000,0000,0000,,bathed in sunshine\Nand surrounded by family?
Dialogue: 0,0:09:12.04,0:09:16.04,Default,,0000,0000,0000,,Is everything still being able\Nto feel your fingers and your toes
Dialogue: 0,0:09:16.07,0:09:18.75,Default,,0000,0000,0000,,because they haven't gone numb\Nfrom chemotherapy?
Dialogue: 0,0:09:19.72,0:09:24.06,Default,,0000,0000,0000,,As oncologists, our everything\Nis cancer treatment.
Dialogue: 0,0:09:24.67,0:09:29.96,Default,,0000,0000,0000,,It's radiation and surgery\Nand chemotherapy and novel treatments.
Dialogue: 0,0:09:29.99,0:09:32.38,Default,,0000,0000,0000,,And for us, the worst thing\Nthat could happen --
Dialogue: 0,0:09:32.41,0:09:35.12,Default,,0000,0000,0000,,and I have heard more than one\Noncologist say this --
Dialogue: 0,0:09:35.14,0:09:36.73,Default,,0000,0000,0000,,the worst thing that could happen
Dialogue: 0,0:09:36.76,0:09:39.72,Default,,0000,0000,0000,,is that the patient\Nwill develop metastatic disease.
Dialogue: 0,0:09:39.74,0:09:43.31,Default,,0000,0000,0000,,Or, the worst thing that could happen\Nis that five years from now,
Dialogue: 0,0:09:43.33,0:09:46.42,Default,,0000,0000,0000,,the cancer will grow,\Nand I'll have to give more radiation.
Dialogue: 0,0:09:47.05,0:09:49.67,Default,,0000,0000,0000,,As a patient and as an oncologist,
Dialogue: 0,0:09:49.69,0:09:53.84,Default,,0000,0000,0000,,I would never argue that these\Nare not devastating outcomes.
Dialogue: 0,0:09:53.87,0:09:55.78,Default,,0000,0000,0000,,But are they the worst?
Dialogue: 0,0:09:56.19,0:09:58.69,Default,,0000,0000,0000,,Should cancer control,
Dialogue: 0,0:09:58.72,0:10:01.94,Default,,0000,0000,0000,,be at the center of our thinking, always?
Dialogue: 0,0:10:03.73,0:10:10.73,Default,,0000,0000,0000,,Many unspeakably, unfathomably painful\Nand brutal things have happened to me
Dialogue: 0,0:10:10.75,0:10:14.36,Default,,0000,0000,0000,,because of my cancers\Nand my genetic mutation.
Dialogue: 0,0:10:14.84,0:10:19.03,Default,,0000,0000,0000,,And yet, I consider myself\Nvery lucky indeed,
Dialogue: 0,0:10:19.06,0:10:22.06,Default,,0000,0000,0000,,because the worst thing\Nthat could happen never came to pass;
Dialogue: 0,0:10:22.90,0:10:28.18,Default,,0000,0000,0000,,because I have let devastation\Nand uncertainty sit at the table,
Dialogue: 0,0:10:28.21,0:10:30.71,Default,,0000,0000,0000,,but somewhere off to the side.
Dialogue: 0,0:10:30.74,0:10:33.35,Default,,0000,0000,0000,,When I was diagnosed\Nwith metastatic breast cancer,
Dialogue: 0,0:10:33.37,0:10:37.54,Default,,0000,0000,0000,,I went to Boston for a second opinion,\Nbecause what could I lose?
Dialogue: 0,0:10:37.56,0:10:40.53,Default,,0000,0000,0000,,When my oncologist gave me\Nvery good and very safe
Dialogue: 0,0:10:40.56,0:10:41.94,Default,,0000,0000,0000,,and very standard advice,
Dialogue: 0,0:10:41.96,0:10:44.17,Default,,0000,0000,0000,,I started medical school anyway,
Dialogue: 0,0:10:44.20,0:10:47.21,Default,,0000,0000,0000,,even though I was undergoing\Nactive cancer treatment.
Dialogue: 0,0:10:48.39,0:10:51.40,Default,,0000,0000,0000,,Instead of shying away\Nfrom patients with cancer,
Dialogue: 0,0:10:51.43,0:10:53.77,Default,,0000,0000,0000,,I became a radiation oncologist,
Dialogue: 0,0:10:53.79,0:10:56.26,Default,,0000,0000,0000,,and I work with patients\Nwho are very much like me
Dialogue: 0,0:10:56.28,0:10:57.62,Default,,0000,0000,0000,,every single day.
Dialogue: 0,0:10:58.32,0:11:03.53,Default,,0000,0000,0000,,Instead of imagining the suffering\Nthat I might cause to a future partner
Dialogue: 0,0:11:03.56,0:11:05.62,Default,,0000,0000,0000,,when I died of cancer,
Dialogue: 0,0:11:05.64,0:11:08.56,Default,,0000,0000,0000,,I married my wonderful husband.
Dialogue: 0,0:11:09.40,0:11:11.48,Default,,0000,0000,0000,,Because the worst thing that can happen
Dialogue: 0,0:11:11.50,0:11:14.73,Default,,0000,0000,0000,,is always a series of negatives.
Dialogue: 0,0:11:14.75,0:11:16.86,Default,,0000,0000,0000,,It's blank spaces
Dialogue: 0,0:11:16.88,0:11:18.97,Default,,0000,0000,0000,,that should be filled with life.
Dialogue: 0,0:11:20.35,0:11:26.50,Default,,0000,0000,0000,,So what is the most that I have leaned in\Nto this kind of radical uncertainty?
Dialogue: 0,0:11:27.66,0:11:30.80,Default,,0000,0000,0000,,Well, this is William.
Dialogue: 0,0:11:32.06,0:11:37.69,Default,,0000,0000,0000,,He is the most joyful person\Nthat I have ever met,
Dialogue: 0,0:11:38.69,0:11:43.86,Default,,0000,0000,0000,,and in just over a year, he has already\Nmade the world a better place.
Dialogue: 0,0:11:46.34,0:11:50.26,Default,,0000,0000,0000,,As oncologists, we talk to our patients
Dialogue: 0,0:11:50.29,0:11:52.19,Default,,0000,0000,0000,,as if the worst thing that could happen
Dialogue: 0,0:11:52.21,0:11:54.49,Default,,0000,0000,0000,,is that their cancer could come back,
Dialogue: 0,0:11:54.51,0:11:57.60,Default,,0000,0000,0000,,or that it could spread,\Nor that they could die from it.
Dialogue: 0,0:11:58.07,0:12:00.89,Default,,0000,0000,0000,,As a patient, I know\Nthat these are paramount.
Dialogue: 0,0:12:00.91,0:12:03.81,Default,,0000,0000,0000,,But I want to change the way\Nthat we think about this,
Dialogue: 0,0:12:03.84,0:12:07.60,Default,,0000,0000,0000,,and I want to change the way\Nthat we talk about this with our patients.
Dialogue: 0,0:12:08.17,0:12:09.70,Default,,0000,0000,0000,,As a patient,
Dialogue: 0,0:12:09.73,0:12:14.54,Default,,0000,0000,0000,,the worst thing that can happen\Nis that cancer robs you of opportunity,
Dialogue: 0,0:12:14.57,0:12:16.56,Default,,0000,0000,0000,,of the ability to be
Dialogue: 0,0:12:16.59,0:12:17.90,Default,,0000,0000,0000,,and to do
Dialogue: 0,0:12:17.92,0:12:19.44,Default,,0000,0000,0000,,and to love.
Dialogue: 0,0:12:20.04,0:12:21.57,Default,,0000,0000,0000,,And it will.
Dialogue: 0,0:12:21.59,0:12:24.28,Default,,0000,0000,0000,,At least temporarily it will.
Dialogue: 0,0:12:24.80,0:12:28.03,Default,,0000,0000,0000,,But to minimize this loss\Nof life in the living,
Dialogue: 0,0:12:28.06,0:12:34.43,Default,,0000,0000,0000,,that is the harder, and I would say,\Ntruer job of the oncologist:
Dialogue: 0,0:12:34.46,0:12:38.82,Default,,0000,0000,0000,,to take all the tools that we have\Nand situate them in the context
Dialogue: 0,0:12:38.84,0:12:41.46,Default,,0000,0000,0000,,of a patient's whole entire life;
Dialogue: 0,0:12:41.48,0:12:45.50,Default,,0000,0000,0000,,to be guides for how\Nto sit with suffering,
Dialogue: 0,0:12:45.53,0:12:47.71,Default,,0000,0000,0000,,acknowledge it deeply,
Dialogue: 0,0:12:47.74,0:12:52.82,Default,,0000,0000,0000,,but to not let fear of future suffering\Nbe the narrative for the journey forward.
Dialogue: 0,0:12:54.05,0:12:58.52,Default,,0000,0000,0000,,One of my mentors always says\Nthe medicine part is easy.
Dialogue: 0,0:12:59.57,0:13:03.49,Default,,0000,0000,0000,,And it never feels that way\Nto a junior doctor,
Dialogue: 0,0:13:03.52,0:13:06.10,Default,,0000,0000,0000,,but its contours are finite.
Dialogue: 0,0:13:06.70,0:13:12.68,Default,,0000,0000,0000,,We have big studies to guide us,\Nand it's what we learn to do in residency.
Dialogue: 0,0:13:13.70,0:13:20.69,Default,,0000,0000,0000,,Much harder is learning how to help\Neach patient navigate the multitudes
Dialogue: 0,0:13:20.71,0:13:22.88,Default,,0000,0000,0000,,contained in their illness.
Dialogue: 0,0:13:24.55,0:13:29.62,Default,,0000,0000,0000,,So I find it really funny\Nthat, in retrospect,
Dialogue: 0,0:13:29.64,0:13:32.38,Default,,0000,0000,0000,,my life looks like a neat package.
Dialogue: 0,0:13:32.94,0:13:37.13,Default,,0000,0000,0000,,It looks as if I planned\Neach successive step,
Dialogue: 0,0:13:37.16,0:13:41.62,Default,,0000,0000,0000,,and that perhaps cancer\Nhas led to the good things in my life.
Dialogue: 0,0:13:42.46,0:13:45.67,Default,,0000,0000,0000,,Step one: apply to medical school.
Dialogue: 0,0:13:45.70,0:13:49.11,Default,,0000,0000,0000,,Step two: get diagnosed with\Nand treated for cancer.
Dialogue: 0,0:13:49.13,0:13:51.58,Default,,0000,0000,0000,,And step three: have it all,
Dialogue: 0,0:13:51.60,0:13:54.08,Default,,0000,0000,0000,,a career and a family.
Dialogue: 0,0:13:55.27,0:13:57.19,Default,,0000,0000,0000,,But I will tell you
Dialogue: 0,0:13:57.94,0:14:02.59,Default,,0000,0000,0000,,that each phase was a leap of faith
Dialogue: 0,0:14:02.61,0:14:06.87,Default,,0000,0000,0000,,despite an almost paralyzing uncertainty.
Dialogue: 0,0:14:08.10,0:14:09.80,Default,,0000,0000,0000,,And so it's that courage
Dialogue: 0,0:14:09.82,0:14:12.70,Default,,0000,0000,0000,,that I try to give to each of my patients.
Dialogue: 0,0:14:13.29,0:14:17.50,Default,,0000,0000,0000,,I try to do this regardless\Nof the technical medical details
Dialogue: 0,0:14:17.52,0:14:19.65,Default,,0000,0000,0000,,of cancers and treatment decisions
Dialogue: 0,0:14:19.68,0:14:21.40,Default,,0000,0000,0000,,and mutations,
Dialogue: 0,0:14:21.42,0:14:24.28,Default,,0000,0000,0000,,regardless of the slippery fiction
Dialogue: 0,0:14:24.30,0:14:25.83,Default,,0000,0000,0000,,of prognosis.
Dialogue: 0,0:14:26.64,0:14:29.48,Default,,0000,0000,0000,,I try to learn what they want
Dialogue: 0,0:14:29.51,0:14:31.44,Default,,0000,0000,0000,,and what they need,
Dialogue: 0,0:14:31.47,0:14:34.89,Default,,0000,0000,0000,,what they wish and what they worry,
Dialogue: 0,0:14:36.24,0:14:39.12,Default,,0000,0000,0000,,what they dream about,
Dialogue: 0,0:14:40.40,0:14:43.26,Default,,0000,0000,0000,,what animated them before
Dialogue: 0,0:14:43.28,0:14:49.90,Default,,0000,0000,0000,,and what will sustain them during\Nthe beastly process of cancer treatment.
Dialogue: 0,0:14:51.08,0:14:54.54,Default,,0000,0000,0000,,It doesn't actually take that much time.
Dialogue: 0,0:14:55.75,0:15:00.34,Default,,0000,0000,0000,,It does take a few focused, quiet moments
Dialogue: 0,0:15:00.37,0:15:03.80,Default,,0000,0000,0000,,that require intentional cultivation.
Dialogue: 0,0:15:04.96,0:15:07.43,Default,,0000,0000,0000,,But this is partnership,
Dialogue: 0,0:15:08.49,0:15:10.48,Default,,0000,0000,0000,,and it matters,
Dialogue: 0,0:15:11.54,0:15:14.59,Default,,0000,0000,0000,,because the worst thing that can happen
Dialogue: 0,0:15:14.61,0:15:20.92,Default,,0000,0000,0000,,is to have an oncologist\Nwho does everything -- everything --
Dialogue: 0,0:15:20.94,0:15:24.08,Default,,0000,0000,0000,,to help cure your cancer
Dialogue: 0,0:15:24.10,0:15:26.40,Default,,0000,0000,0000,,and who does nothing
Dialogue: 0,0:15:26.42,0:15:29.02,Default,,0000,0000,0000,,to help you live your life.
Dialogue: 0,0:15:30.59,0:15:31.91,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:15:31.94,0:15:36.46,Default,,0000,0000,0000,,(Applause)