What if it is cancer?

A medical student contemplates the other side of medicine

Here I am, waiting. One week ago I went to see a consultant surgeon at the local hospital. I have found a lump in my breast, you see. I found it a while ago but dismissed it. It was painful and therefore I decided I shouldn't worry, so I didn't. But I thought, what the hell, I'll go and see the nurse at the local general practice and see what she thinks. I was doing just fine until I got undressed and told her my thoughts. She was lovely and kept telling me she didn't want me to worry. I didn't until her fingers identified the same lump that I had found. I hadn't told her where in my breast I had located it but I knew by the look on her face that she had felt something.

She called in one of the female general practitioners to see me. Again, words of kindness and consideration were spoken. The doctor, although seeming less sure of the lump and looking somewhat tired, agreed that I should be sent to the express breast clinic, so that's where I was two days later. They told me it was just a precaution and as a medical student they didn't want me worrying. When I got home from the surgery I broke down in tears as I digested what was happening. I had to tell my mum; she knew I had been to the surgery and was therefore curious as to why. I hadn't wanted her to worry - I didn't so why should she? But now, now I needed her. It was horrible. I felt as if I was in a whirlwind.

At the clinic the consultant was lovely. He cared about me; maybe he had a daughter or son around my age. He listened to me, examined me, and agreed that he could palpate something in both breasts. All the time I am thinking that all of this information leads me to believe that it is benign; come on, I only did this two years ago as a specialty so surely I can remember this. I was sent for an ultrasound immediately and there was nothing of interest, "benign thickening" is a great way to tell me nothing at all. No discrete mass, none visible anyway. Both breasts looked pretty similar in the black and white cross sections I was shown. So that was that. The consultant saw me again said I shouldn't worry but that I should be vigilant. I should also get checked again in six weeks. So here I am, one week later, knowing that it is only five weeks away. It is difficult to explain why I am so frightened, after all I have been told I shouldn't be worried.

But, you know what, nothing anyone might say right now would help unless they could say point blank "You do not have cancer." I feel frightened, I feel alone, and I feel mystified as to why I, as member of the medical profession, cannot get a grip on this. I am angry with myself - why can't I just accept that I am fine? It is as if you become someone else when you become the patient. I have been in breast clinics hearing the diagnosis for other women and, although I have felt sympathy and, in the words of the medical educators, I have tried to empathise, now I am realising just how patronising that is. No one knows how I feel right now, no one can. Many women will have been faced with this situation, and some will, no doubt, have coped incredibly well; others I fear will have suffered more than I am.

Yes, I know I haven't been told that I have cancer. Yes, I know it is procedure to follow up in six weeks; yes, I know with my family history (no history of breast cancer) and my age (23) that there is very limited statistical evidence to make me believe I could have this, but this does not help. Right now I am frightened, intimidated by the fact that I can not control my fear, and embarrassed by my reaction to this. I wish the lump would just disappear. So, now I have another five weeks to wait. Probably I will be fine, probably I am worrying over nothing, but if all goes well I know that I will have been changed by this experience, reminded of what it is to be dependent, frightened, and alone. However many people hold my hand, I am still alone.

Well here I am, three days to go until the follow up appointment, and my article has been returned to me to add some more words. I feel differently now than I did when I wrote the piece above; now I am just desperate to get this over with. My concerns are more focused. But so many questions plague me. As my friends worry about finals I worry about this. Maybe you know me, maybe you've seen me before in lectures. I am one of you, and now I am one of "them"; a frightened patient. Monday will come and go, and I hope it is fine, I hope they give me the all clear, and I hope that I will never forget what it is like to be faced with such uncertainty and will remember it the next time I talk with a patient.

During this time I have realised that I am not alone, as I thought I was five weeks ago - at least no more than I was before all of this started. I have the support of all those who know about this, and I am beginning to see more clearly what it must be like for those with no one to go to the appointment with them, no one to cry with them, and no one to care for them. I am lucky. Incredibly frightened, but lucky all the same.

Name and address supplied


studentBMJ 2000;08:89-130 April ISSN 0966-6494