How work kept me going during my cancer treatment

When lawyer Sarah Donnelly was diagnosed with breast cancer, she turned to her friends and family for support -- but she also found meaning, focus and stability in her work. In a personal talk about why and how she stayed on the job, she shares her insights on how workplaces can accommodate people going through major illnesses -- because the benefits go both ways.

It was June 2014.

I was 30 years old,

and I received a call
from my doctor's office

to say my test results were in.

So I walked up to see her
in my lunch break, and my doctor said

she was very sorry to tell me
that I had breast cancer.

I didn't want to believe her
and at first, I didn't.

You see, I'm a lawyer
and I needed some evidence.

So I'm very embarrassed to tell you all

that I stood up and I walked around
to where she was sitting

so that I could look
over her shoulder and verify

what was written
on the page in front of her.

(Laughter)

Malignant carcinoma.

But still not wanting
to believe it, I said,

"Now, malignant carcinoma,
you're sure that means cancer?"

(Laughter)

She told me she was sure.

Back at work, I handed over
the urgent things that needed to be done

while I was having more tests
to see if my cancer had spread.

But at that moment,
work wasn't my priority.

I was thinking about how I was going
to tell my family and friends

that I had cancer.

How I was going to answer their questions

about how bad it was
and whether I was going to be OK,

when I didn't know that myself.

I was wondering if my partner and I

would ever have an opportunity
to start a family.

And I was figuring out
how I was going to tell my mother,

who had herself had breast cancer
when she was pregnant with me.

She would know how I was feeling

and have an idea of what lay ahead for me.

But I also didn't want her
to have to relive her cancer experience.

What I didn't appreciate at the time

was that work was about to play
a huge role in my treatment and recovery.

That it would be my coworkers and my job

that would make me feel valuable and human

at times when I would have
otherwise felt like a statistic.

That it would be my job
that would give me routine and stability

when I was dealing with so many
difficult personal decisions

and so much uncertainty.

Like, what sort of breast
reconstruction I was going to have.

And at a time like that,

you would think that I would turn
to my family and friends for support.

And yes, of course I did that.

But it would ultimately be my colleagues

who would play a huge role
in my day-to-day life.

And they would be
the ones to make me laugh.

You see, we were a pretty close team,

and we shared a couple
of really good in-jokes,

like this time they overheard
someone ask me

how I got my hair so shiny and perfect --

without knowing that it was,
of course, a wig,

and you know, it was a very good wig

and it did make getting ready
in the mornings very easy.

(Laughter)

But in little moments like this,
I appreciated what their support meant,

and I wondered what I would
have done without that network.

I've spoken with so many people,
women in particular,

who haven't had the chance
to have that network

because they haven't been given
the opportunity to work through treatment.

And there are several reasons for this.

But I think it mostly comes down
to overly paternalistic employers.

These employers want you to go away
and focus on yourself.

And come back when you're better.

And they use those kinds of phrases.

And while these responses
are well-meaning,

knowing the benefits it brought me,

it makes me incredibly frustrated

when people are told
that they couldn’t or shouldn't work,

when it's something that they want to do
and physically can do.

So I started to look into
what an employer is required to do

when someone presents
with a cancer diagnosis.

I discovered that under Australian law,
cancer is considered a disability.

So if you are unable to perform
your usual work duties,

your employer is obligated
by the Disability Discrimination Act

to make reasonable adjustments
to your working arrangements,

so that you can continue to work.

What would reasonable
adjustments look like for me?

I knew the obvious impacts
my diagnosis was going to have on work.

Medical appointments would be scheduled
during business hours,

and I knew that I would need time off
to recover from surgical procedures.

Again, being a typical lawyer,

I had done my due diligence
on what to expect from treatment.

Admittedly, a lot of that
was through Doctor Google,

perhaps not my best move
and I wouldn't recommend that.

(Laughter)

But while I was ready
for all the physical side effects,

what really scared me
was this thing called chemo brain.

Chemo brain presents itself
through memory loss,

an inability to concentrate

and an inability to solve problems.

And if this happened to me,

I wondered how I was going to do
my job as a lawyer.

Would I be forced to leave work?

And how could I possibly
have a discussion with my manager

about reasonable adjustments
to my working arrangements

when I didn't know
how I was going to be impacted?

I was fortunate to have
a supportive manager

who was happy to see
how things went as we went along,

rather than requiring
a concrete plan up front.

I was lucky that while
he may not have even known

about this concept
of reasonable adjustments,

to him, it was just common sense.

But I've learned that it's not
common sense to everyone.

Everyone going through treatment
will learn how it impacts them

and what their limitations are.

And they'll learn to adjust for that.

So for me, there were the tips and tricks
that I learned about the treatment itself,

like, before you go to chemo,

you need to make sure
you're really well hydrated

and that you're warm, because it helps
the nurses to find your veins.

And make sure that you don't eat
any of your favorite food,

either before or after chemo,

because you're going to be
throwing that up

and you won't ever
want to look at it again.

(Laughter)

I learned that one the hard way.

And then there were the tricks
for managing my workflow.

I scheduled chemo for first thing
on a Monday morning.

I knew that from the time
I left the cancer care unit,

I had about four hours
before this fog screen would come down

and I would start to be sick.

So I would use that time to clean my inbox
and make any urgent calls.

The worst of the sickness would be gone
within about 48 hours.

And then I would log back
into work from home.

This treatment continued
and I knew what to expect.

I was able to set reasonable expectations
with my business partners

about what I could do

and the time frames that I could do it in.

But I still remember
the hesitation in their voices

when it came to asking for things.

And asking me to do things
by a certain time.

And trust me, these were people

that were not afraid
of setting a good deadline.

(Laughter)

I got the impression they didn't want
to put any extra pressure on me

while I was going through treatment.

And while I appreciated the sentiment,

I actually needed the deadlines.

To me, that was something
within my control

and something
that could stay in my control

when there were so many
things that couldn't.

And as I was working from home,

I was thinking about how employers
should be applying this concept

of reasonable adjustments
in our current age,

where one in two Australian men and women

will be diagnosed with cancer
by the age of 85.

So, as we continue to work
longer and longer into older age,

the chances of having a serious illness
while we're in the workforce

are increasing.

And with technology enabling us
to work anywhere, any time,

reasonable adjustments
are no longer contingent upon

whether or not you can continue
to physically make it

into the physical office.

Reasonable adjustments are also not about

just offering a longer break
or a comfier chair to sit in,

although those things might be good, too.

At the very least,

we need to be applying
the flexibility policies and strategies

we've developed for other scenarios,

like for people
with family responsibilities.

But how can we ensure that people
are even having a conversation

about what reasonable adjustments
might look like for them

if a manager's first response is to say,

"Oh no, don't come back to work
until you're better."

And a light went on for me.

It must be compulsory for managers

to have to have these conversations
with their employees.

And lessons from people like me,

that have really benefited
from working through treatment,

need to be more widely shared.

And I thought about what could be done
to guide these conversations,

and then an amazing
colleague of mine, Camilla Gunn,

developed a "Working with Cancer" toolkit.

The toolkit provides a framework
for those diagnosed,

their managers, their carers
and their coworkers

to have conversations about cancer
and the work support available.

Camilla and I have now been
to other organizations

to talk about the toolkit

and how it can help to guide through

what, quite frankly, are otherwise
some pretty awkward conversations.

And I'm pleased to say that the uptake
of the toolkit is increasing.

So what should be
a manager's first response

when somebody says that they're sick

and they don't know
how it's going to impact their work?

It must be this:

"To the extent that you
are able, and want to,

we would love to work out
an arrangement for you

to continue to work through treatment."

We need to start positively engaging
people with serious illness

to keep them in the workforce,

rather than paternalistically
pushing them away.

I've told you my story
because I want you to know the benefits

that working through treatment brought me.

And I also want to change your perceptions

if you think that somebody
going through treatment

is just bored, frail and vomiting a lot.

And yes, these things
were true some of the time,

if not a lot of the time,

but I was also determined
to push myself at work

as much as I had always done.

And I was able to do that
because my employer gave me the choice.

Most importantly, I'm telling you

because while it's a seemingly
obvious choice to give someone,

it's not one that is always
offered or encouraged.

And it must be.

Thank you.

(Applause)