Facing life and death, with cancer | Kat McHale | TEDxExeter

How would you live if you knew you might die soon? Kat McHale has been forced to confront her own mortality since being diagnosed with breast cancer at the age of 34. In this deeply personal talk, she reflects on what’s most important in her life - and invites you to do the same.

Kat McHale is a public health doctor and mother of three young children. In October 2018, she was diagnosed with breast cancer.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

Dying.

It's not something
we think about much, is it?

I'm a doctor.

And as a doctor, death and dying
have been part of my working life.

I've cared for people, young and old,
people with terminal illnesses,

people who've suffered
acute illnesses or tragic accidents.

I've lost family members and friends too.

But despite this, I'd never given
much thought to my own death -

to me dying.

People say, "You might
get hit by a bus tomorrow."

Well if my mortality was a bus,

it was always something I could just see
out of the corner of my eye

way over there.

I knew it was there; we all do.

But I would go about my daily life -
work, the shopping, the school run -

without giving it a second thought,

assuming it would remain
far off in the future,

not coming into full view until I'm old.

But what if we did
think about our own deaths?

Really think about it.

What would we do differently?

What would we do to prepare?

And how would we live that
in the everyday?

It all changed for me last October.

I was 34, with three small children,
and plans for the life ahead of me.

I'd noticed a lump and been
referred to the breast clinic,

where I had a mammogram,
ultrasound, and a biopsy.

I had to wait a week for the results.

Even though I knew
cancer was a possibility,

I still didn't really believe it could be.

So, as my husband works away from home,

I went to the appointment alone.

Suddenly that bus was right here,
right in front of me.

Cancer.

What thought I had given to my own death
had always been fairly abstract.

When we had our first child,
I'd done the sensible things -

I wrote a will, got life insurance -

but I never truly thought
about the reality of it.

The reality of the things
I might never do,

or the realisation that I might be
doing something for the last time.

Being forced to confront
our own mortality is terrifying,

but now, suddenly, I had to.

It can be hard,

dealing with people's reactions.

No one really knows what to say,

and sometimes I feel it's me
who needs to support them.

I can talk to people about my cancer

in a practical, matter-of-fact way
without getting upset.

I cry with my husband.

But I don't want to be
crying in front of everyone.

It was difficult, telling my children.

My girls, aged six and four,
and my little boy, who's two.

When I was diagnosed, I was given
a picture book called "Mummy's Lump",

which we read together.

I didn't want to hide
from them what was going on,

for them to know something was wrong
but to not know what it was.

My four-year-old
especially enjoyed the page

where mummy has lost all of her hair

and her wig is hung up
as she asks in a fit of giggles,

"Why's mummy taken her hair off?"

(Laughs)

People ask about my risk factors.

Often they are looking for reassurance,

for me to give them a reason
why this has happened to me,

to tell them, "Don't worry,
it won't happen to you."

But I can't.

I'm young.

I don't have a strong family history
of breast cancer

or any other particular risk factors.

I breastfed all three of my children,

which is protective,

and yet, here I am.

We assume bad things
always happen to other people.

We ask, "Why me?"

But from my years as a doctor,
I'm all too aware

that the real question is, "Why not?"

The truth is our lives
can change or end at any moment.

That bus can go
from there to here like that.

I've been thrown into non-stop
appointments: breast care nurses,

breast surgeon, plastic surgeon,
radiologist, oncologist,

chemotherapy nurses,
counsellor, wig fitting.

Even a make-up session where I learned
to fill in my thinning eyebrows.

There's a huge amount of information,
so many decisions to make.

What type of surgery to have.

It's hard to take it all in.

They told me not to rush
into any decisions,

decisions I might come to regret.

But all I want is to survive,

to survive to be able to have regrets.

As time's passed, I've realised
that the bus isn't here,

right in front of me.

It's further away.

I'm not going to die
tomorrow or next week

or even next month.

I can still see it though.

It's coming and I feel like I can't move.

After being told I had cancer,

one thought was
at the forefront of my mind:

What do I do now?

I wondered if I needed
to go to Disneyland.

(Laughter)

They don't give you a handbook
when you're diagnosed.

They don't say, "You've had some
terrible news, here's what to do next."

So I started asking people -
family, friends, hospital staff -

"What do I do now?"

Each time, the same reply:

"Do what's right for you."

But I didn't know what was right for me.

I'm someone who likes a plan;

I want to tick things off,
to know that I am making progress.

So I started making a list.

A few things immediately came to mind.

I finally organised
a christening for our son

that had been on my to-do list
since he was born two years ago,

but I just hadn't got around to it.

We didn't have any pictures
of the five of us together,

so I arranged for us to have some
professional family photos done.

I wanted to get them done quickly
before I started my chemotherapy

and lost all of my long dark hair.

We did the photoshoot
at home in our garden.

The photographer explained it's easier
to manage the children in a small space,

otherwise, we'd just end up with lots
of pictures of them running away.

(Laughter)

Even in our garden, though,

it was a challenge
to get them to keep still.

In the end, we had
to bribe them with breadsticks.

Friends have since commented
that that was a pretty rubbish bribe.

(Laughter)

But it worked!

(Laughs)

I struggled to come up
with a "Bucket List".

I spent a long time thinking about it.

What do I really want to do before I die?

But I realised I don't want to climb
a mountain or see the pyramids.

All I truly want is to raise my children.

But that isn't something
you can simply tick off a list.

So I thought about my children,
what I can do for them,

what I can leave behind
for them to remember me.

I thought about buying them
cards for all the milestones,

all the things you see cards for:

passing exams, driving tests,
buying a house, getting married.

But they might not do any of those things.

Unless something terrible happens,
though, they'll definitely reach 18,

so I've bought them all
18th-birthday presents.

And if I do get through this,
then I'm just being extremely organised.

(Laughter)

Now I'm writing a book for them.

A book with all the advice
I'd love to give them as they grow.

Advice from mummy.

There are so many things I want
to share with them, to teach them,

the lessons I've learnt
from my successes and failures,

to tell them about me and my life,
and to guide them through theirs.

I want to help them
to be confident and resilient,

to not let my illness define them.

We wanted to make some happy memories,
so we did go to a theme park.

Not Disneyland,
but one near where we live.

We had a fantastic time.

But we can't go to theme parks every day.

The children still need to go to school,
the bins still need to be put out.

The bills still need to be paid.

Sometimes it just feels
like I've added breast cancer treatment

to all of the other things
I'm trying to juggle.

People tell me I'm brave,

but I'm not.

I have to get on with it;
what other choice do I have?

I'm trying to be positive, to make plans.

We're hoping to take time out
from work and travel as a family.

But I know those plans
might not be realised.

I don't know what will happen.

I finished my chemotherapy.

Last week I had surgery.

And soon I'll start radiotherapy.

The statistics tell me that this
treatment plan improves survival,

but that's meaningless
if it doesn't work for me.

All of the talk of fighting,
battling, beating cancer

for me implies that if you don't make it,
you haven't tried hard enough.

As a doctor, and now as a patient,

I know that that's not fair.

It's out of my hands.

Even if the treatment is successful,

I know the cancer could
come back years later,

or there could be complications
from the treatment down the line.

I could worry about it, always.

I've noticed though that I've let
the bus slip back out of view.

When I received my diagnosis,
it was right here, right in front of me.

Facing it made me sick with worry.

I was desperate to go back to the time
when I could just get on with my life

without thinking about my death.

But now, letting it move out of sight,

letting go of that sense of urgency,

worries me too.

I don't want to get to the end
of my life and have regrets.

Having to face my own mortality

in many ways is helping me to focus
on what's important to me

and to grasp each moment.

I've stopped keeping things for best.

I wear my best clothes,
and I light my best candles.

We don't often talk about death.

And when we do, we talk
about other peoples deaths,

or we talk about it in an abstract way.

But that's not the same
as really facing it.

We are all going to die.

Any one of us could get hit
by that bus tomorrow.

So what if we did think about it?
Really face our own deaths?

What would you differently?

What would you do to prepare?

And how would you live
really knowing that you will die?

Everything in my life has shifted.

Maybe the bus will swerve, maybe it won't.

I can't make assumptions about my future.

I may not have time
to do all I want to do.

But that was always true,

I just didn't think about it.

For now, though, I'll cherish
each moment with my children,

chasing them around the garden
and bribing them with breadsticks.

(Laughter)

Thank you.

(Applause)