I walked home. For the time of year, it was warm enough and I needed to just think. From the lot where my Jeep is parked on a daily basis to our house, it is probably a 15-minute stroll. I tried to process what had just been revealed an hour or so before. I had called Kristi and broke the news. Of course, I would later find out, what the resident told us wasn’t 100 percent accurate, so when I told Kristi what he had told me, google searches painted a very bleak, almost damning, picture.
For chapter one, read: A CANCER DIAGNOSIS DURING MEDICAL SCHOOL: BECOMING THE PATIENT
A WIFE’S VIEW
When Blade had come home two days previous and told me that his path report had come back pretty much as a 99 percent chance of having cancer, it was like I was hit with a bucket of ice water. That cold shiver and shock went through my body like pins and needles. This wasn’t happening.
I was prepping to cook some chicken so my hands were covered in raw chicken juice. I stood there frozen in the kitchen with my hands up as I listened, not fully processing what Blade was saying. I was paralyzed, wanting to go hug him, but not able to move from shock and the fact that my hands were gross and sticky. I quickly finished prepping the chicken and got it in the oven, washed my hands, and rushed over to give him a hug. I tried to focus in and asked him to explain it to me again.
Fast-forward to April 22. We still hadn’t received any more information. Blade had gone back in for clinic that morning. We were at a nearby park when I looked at my phone, four missed calls from Blade. I quickly called him back. It was cancer. 3B is what the resident said.
We both had been prepping ourselves for the official diagnosis. I breathed. Took it in and tried to be as positive and supportive as possible. We would get through this. We would figure this out together. It would work out in the end. We had been praying fervently the past two days and felt peaceful about it. It would work out, but we also still felt scared and nervous of the what ifs.
A GRIM PROGNOSIS
He said he would be walking home to clear his head and would see me shortly. We hung up. I quickly texted my family, who we had asked to fast and pray for us, to give them an update. I had been pushing my kids on the swings and I then made the big mistake of Googling melanoma 3B. This article by healthline first popped up…
The survival rates for stage 3 melanoma vary based on the size of the primary tumor and how far the cancer has spread into the lymph nodes and other organs.
According to the American Cancer Society, the five-year survival rate for the stages are:
stage 3A: 78 percent
stage 3B: 59 percent
stage 3C: 40 percent
The 10-year survival rates are:
stage 3A: 68 percent
stage 3B: 43 percent
stage 3C: 24 percent
59 percent. I immediately started bawling. I crumpled down into a ball in the middle of this park and bawled like a baby. Gratefully it was only us. Both of my kids stared at me from their swings not knowing what to do.
According to the stats, there would be a 40 percent chance I’d loose my husband in the next five years. I would be a widow and a single mom. This wasn’t part of the plan.
My phone was dinging with texts of love and support from my family. A Marco Polo came in from one of my sisters and I quickly responded, hyperventilating as I talked to her.
Hazel began asking me what was wrong and why I was so sad. How do you explain to your 3-year-old the gravity of the situation? I told her that we were going home. Daddy was very sick and needed help from special doctors.
Hazel patted my back and said, “It will be ok Mommy. Daddy can go to a doctor appointment and feel better.”
I said, “I sure hope so. Let’s say a prayer right now and then Daddy and I will explain more when he gets home.”
CANCER STAGING
There are two big players in cancer prognosis determination. There is grading and there is staging. Grading is how bad the tumor itself is, simply put. Staging is how much the tumor has moved. Staging uses the TNM system. T references the tumor itself, M is metastasis (did it move to other body parts at all), and N is lymph nodal involvement, typically the first place cancers go if they leave their first home. You can have a high grade but low stage cancer, which is much better than a low grade, high stage one. The tumor can be quite knarly looking per grading, but if it hasn’t gone anywhere, melanoma is pretty treatable. Call the surgeon, cut it out, go home. But, if the little cancer cells have snuck out of the original location, prognosis can decline quite rapidly.
The resident had told me that my melanoma STAGE was stage 3, meaning it was one step away from most likely game over. I was confused because in order to stage something, it involves looking at nodes via biopsy, imaging, etc. We hadn’t done any of that. I had asked the resident about this discrepancy, but he said “we stage melanoma differently”.
That is true, somewhat. We use the Gleason Score in prostate cancer. It is unique to prostate cancer, but it helps someone GRADE the tumor, not STAGE it. This resident, whom I don’t feel was being malicious or [insert any other negative word here], kept saying the stage was what they had determined. I chalked it up to not being a dermatologist and not understanding melanoma cancers all that much. Maybe my stage could be determined by a shave biopsy alone. But still…
NOW WHAT?
As I walked home, it was sunny but breezy. It was warm enough to not shiver, but cool enough to keep my suit jacket on for comfort. I realized during my walk that processing this new diagnosis would take time, much more time than 15 minutes. So, I asked who I needed to let know beyond my wife. My mom? Definitely not. Not this early without any super clear answers. My dad? He was in town when my genetic test had come in suggesting possible melanoma, so maybe bring him up to date later.
My thoughts turned to my schooling.
If my cancer was super aggressive and this was my endgame, I didn’t want to spend anymore time away from my children. Don’t get my wrong. My medical training has been beyond exciting, fulfilling, and fun. I can’t picture doing anything else. But, if time was limited, I needed to use it to raise my kids as much as possible. I needed to make memories with them so they remembered their late father. What a thought to have as a 28-year-old. I needed to spend time with my Kristi. I needed to be present daily, especially if decades and years would be dwindled to months and weeks.
So, I ended up calling someone I will refer to as the medical school mom (MM). This lady is nothing short of amazing. She is a warrior, a defender, an advocate, and a friend. She has been my point person to let know when things in life have changed throughout my time at Mayo. MM is a God send, a mountain among men.
I called her and broke the news. She instantly was asking every question I had been asking myself. Full of love and concern. She asked if she could call a second individual I will refer to as Dr. Awesome. I said sure. Dr. Awesome is a dean in our school and it was more than appropriate to inform her as my time at Mayo as a medical student very likely was coming to an abrupt close. I had ZERO ideas what the next steps were. For feeling so focused just a few hours before, I was so lost.
NO BETTER PLACE THAN MAYO
Not two minutes after I got off the phone with MM, Dr. Awesome rang me. Instantly, she asked question after question about what I knew at this point and what plans were in place for treatment and/or follow up. She also questioned the staging. Grading seemed more likely. This was too early for staging to be confirmed. I could tell not only was she worried, but she was determined. She has the sass of sailor. She is fiercely dedicated and loyal. You want her in your corner even when fighting in a circular arena. She asked me to be patient and give her ten minutes and she would be in touch. Sure, I may only have another 525,600 minutes left, so giving up ten was easily manageable.
When I walked in the door, I instantly hugged Kristi. What was going to happen next? Was this it? Was my life going to be a child’s picture book or a novel?
That soon became somewhat clearer when eight mins after hanging up with Dr. Awesome, she was calling again. She said to go back to Mayo. I was meeting with Dr. M, a doctor I would later learn is known as the god of melanoma research and treatment. It can take months to get into an appointment with him; I had one in 30 minutes.
I quickly changed, not knowing what the day would bring, but feeling like if having cancer was going to be part of my story, then there was no better place to be than right where I was.
Often I have joked that I am nowhere near smart enough to be at the Mayo Clinic Alix School of Medicine. The people I work with, my classmates and friends, are brilliant. Even that word doesn’t quite capture their abilities. The sole reason I got in, continuing the joke, was because the only way I would stay alive long enough to become a doctor was if Mayo was the system taking care of me during my training. That joke wasn’t funny anymore because, in all reality, it was turning out to be very, very true.
Chapter 3 coming soon…
Connect with me on Instagram or Facebook for the daily fun (and grind) between posts. To connect with Blade check out his Instagram – @dr.bladeinprogress
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