Sunday, August 28, 2016

When You're a Resident and Your Husband Has Cancer

Editor's note: Here is a follow-up post to one from this spring about being a medical student and wife of a newly diagnosed cancer patient. Both are cross-posted from Dear Husband's CaringBridge page.

Back in April I wrote about the bewildering experience of navigating healthcare as a wife/partner rather than as a medical student/insider. Several months and transitions later, I thought it mete to follow that up with a reflection on being a physician-in-training with a spouse who is also a cancer patient. Because we have moved to a new place and are establishing ourselves in a new community, there has been a constant internal tug of war between over- and under-sharing, between controlling how we are perceived and sharing information on a need-to-know basis.

I have not disclosed Dear Husband's diagnosis to many people involved in my training programs (Med-Peds, Internal Medicine, and Pediatrics). In part this is for his privacy among people he has not met and might not meet, which is also why we have posted nothing on Facebook, where it could be visible to mere acquaintances and to friends of friends. In part this is because I do not want "cancer" to be the first thing people think of when they hear his name or do eventually meet him. I did tell the Med-Peds program leadership as soon as I Matched in March--even before we knew the histological diagnosis--because whatever it was, the treatment was probably going to overlap with the beginning of residency and possibly impact my ability to do my job. The first time we got together in person, I also told the other three Med-Peds interns, because they are going to be my closest friends and colleagues for the next 4 years.

When anyone else has asked if I am married, I tell them I have a talented and funny husband who is looking for work, but I omit to mention that DH has been sick. During Peds orientation, I almost revealed our story during a session when one of the program directors asked us to share good and bad doctor encounters. I was screwing my courage to the sticking place to tell the room about his oncologist in Champaign going above and beyond for us—when the session came to a close. So I kept my mouth shut. Ever the optimist, I hoped that DH would have recuperated enough by picnic time to meet my colleagues, and if not, it would soon be a distant memory, something that happened the year I graduated from medical school.

DH's last chemo infusion fell on my first full day of residency. I had arranged for new friends in town to drive him to and from the cancer center, and to check in on him during the day while I was gone. That all went out the window in the evening, when I got a text message at a residents' potluck that he was throwing up and feverish. When I brought him to the ER, I was still in my scrubs from the NICU. Knowing the workflow of an ER, I called the Med-Peds chief resident to tell him that I expected to spend all night there and doubted I could show up for work at 6am the next day. He instructed me to call jeopardy* for my second-ever day as a resident. This meant I had to tell the Peds program leadership what was happening (Hi, I’m a new intern, my husband has cancer, and can you find someone else to work for me tomorrow, please?), as well as my co-interns. Needless to say it meant for an awkward third day of residency, when I showed up again apparently well. During a quiet moment, the attending commended me “for your dedication to your boyfriend”—and I had to tell her it was actually my husband of almost 11 years.

Having opened myself up to the issue, however, I did have a really moving conversation with my teammate about her father, who died of cancer when she was young, and how we wished others would respond to us as loved ones of cancer patients. When she encounters people who worked with her father, they perseverate on the tragedy of his short career and early death, whereas she would like them to tell her stories about the man she barely knew, about his personality, practical jokes, and little quirks. I also want people to know this thing about DH without making it the most important part of him.

On a recent Saturday at the hospital, my senior resident asked what I was going to do with my Sunday off. I mentioned that I wanted to work on a couple of projects, one being my #TeachingRounds posts. She wondered what the other project was, and since we two Med-Peds residents were alone, I told her it was this essay. She was shocked to hear that an otherwise healthy 44-year-old marathon runner developed a massive tumor in his chest and underwent four rounds of chemotherapy in two states, while friends and family got us moved, and I started residency. Whether because we have had five months to absorb the information, or because we have largely overcome this experience, I am no longer shocked—but maybe I should be.

I have noticed already that working in an environment in which bodies, patients, parents, and doctors misbehave, a treatment complication or an object in a body cavity is rarely unusual enough to register on the geiger counters of our OMG meters. Our thresholds for shock have increased, and the astonishing, even the traumatic, has become the currency of our watercooler conversations. This was demonstrated for DH last night at another potluck dinner, as we traded stories with subtle one-upmanship. Perhaps not coincidentally, the Peds program is holding a communications course this coming week for all residents; interns will practice breaking bad news—like a cancer diagnosis—with sensitivity.

If I were being less cautious and more attention-seeking, it would be easy to win that game: My husband was diagnosed with cancer the week after The Match. His tumor was 17 centimeters across. He developed rare and scary side effects. He spent 2 nights in the Surgical ICU with blood pressures so low no floor nurse would take care of him. His oncologist has never seen such a large tumor shrink so much. The man around that lump of metabolically inactive scar tissue remains as funny, caring, and talented as ever. It was in the center of him but never was the center of him. If and when I share DH’s diagnosis with my residency colleagues, that is what I want them to know about my husband.

*Some (most?) residencies require you to work exactly the number of days in your contract, and if you need a sick day, you have to “pay it back” by giving up a day of vacation later. My residency has a “jeopardy” system, where senior residents spend a week or two covering for all the other residents who get sick or have a family emergency.

Tuesday, August 23, 2016

That's So Pittsburgh: Steelers Swag

Spotted on a walk in our neighborhood one evening. The Commonwealth of Pennsylvania only requires a rear license plate, so your front plate can be a vanity. DH and I have blank spots on the front of our cars. He got the usual white-blue-yellow PA plate, but I think they're ugly, so I donated $35 to the Wild Resource Conservation Fund for a "personalized" plate with an otter on it.

Wednesday, August 17, 2016

That's So Pittsburgh: A Love as Strong as Steel

Ever the romantic, Dear Husband has tried to mark many of our anniversaries with a theme gift. The 1st wedding anniversary is supposed to be "paper," so he bought me a book (Eugene Peterson's The Message). For our 5th dating anniversary, he sent me five wooden roses that now live in a vase on his bureau with the three more he received while hospitalized for his first three rounds of chemotherapy.
Strong as Steel
(click for the original music video by British pop group Five Star, 1987)

This love is as strong as steel
Can't break it up or break it down
It's always gonna be around
This love is a love that's real
It's as deep as any ocean goes
It's gonna last, don't you know?
This love's strong as steel.

Even through the times when times were hard for us
Any rain we came through shining
Oh, I knew we'd make it all it takes is trust

A few days before our recent 11th wedding anniversary, it suddenly occurred to me that I should get DH a gift. I gave up an evening of studying to search the web for a suitable present made out of steel: cuff links, bottle openers, and dog tags just did not appeal to me and don't sound like him at all. Finally I stumbled upon Cut Maps, a company that cuts city maps out of shiny steel plates and frames them in modern, black frames. The finished pieces look like abstract art. I decided to buy one map of Baltimore, where we met, fell in love, and got married, as well as one map of Pittsburgh, the city where we will (hopefully) establish ourselves and live many years.

How appropriate to be celebrating our "steel" anniversary in the Steel City!
We had dinner at a restaurant called Eleven, naturally.

DH's card concludes, "...I'm glad we never let go." This was taped to the envelope:

Saturday, August 13, 2016

That's So Pittsburgh: No Right Angles

Friday night Michael and I parked at this garage wedged between two buildings, to attend a show at the Arcade Comedy Theater across the street. That's so Pittsburgh, with nary a 90 degree angle in sight.

If you're interested in PGH architecture, you might like this post about Motor Square Garden in East Liberty.

Saturday, August 6, 2016

That's So Pittsburgh: Three Rivers Regatta

While listening to the radio Saturday morning, I heard about this event called the "Anything That Floats" race. I wasn't sure what else was happening at this weekend's regatta, but since I had woken up early and gotten work done, I figured I had some time in the afternoon to find out what the excitement was. Dear Husband humored me, so off we went.

This was the view across the river toward PNC Park from the fifth floor of the garage where we parked. We walked across the yellow bridge on the right, which had been closed to traffic so food trucks and artists could set up in the lanes. We followed the crowd around the baseball park and down to the bank, where we settled in the grass under the hot August sun.

We had arrived just in time to watch the watercraft being launched into the river. This amateur race grants $2,500 to the charity of choice of the first team to cross the finish line maybe forty yards away. Because the "boats" are made of "anything that floats," not all of the boats that were put in the water started the race, and not all of the boats that started the race finished it. But they were fun to look at, no one was hurt, and a good laugh had by most.

After that, DH and I wandered back across the river. On the bridge we passed a bride and groom taking photographs and stopped to congratulate them for choosing such an auspicious day to get married. (For the uninitiated: Saturday was our 11th wedding anniversary.) To the left is Roberto Clemente's statue, where we discovered he was inducted into the Baseball Hall of Fame on this date in 1973. Told you it was an auspicious day.

At Point State Park, the main stage was between bands, so we walked past the enormous booths for commercial fair food and the corporate tents. I picked up a program and a map of Ohiopyle State Park. Then we headed over to the landing pad, where two air stunt men would be landing in just a few minutes. They jumped out of the plane so high up you could barely tell it was an airplane, and it took a minute before they became visible with their parachutes. They wore smoke packs on their shoes for added effect while swooping and looping down to the ground, putting on the brakes at the very last second. That was exciting to watch.

By this point JP had joined us, so we walked to the water's edge to see what else was going on. Apparently Pittsburgh pioneered  Formula 1 boat racing in 1982, and this was its first year back in eight years. We were just in time to watch the light "boats" do time trials. I say "boats," because they looked like nothing so much as mini space shuttles in the water. They zoomed around during the warm up, revving their engines like metallic birds preening and performing a mating dance. Then they all lined up, an amplified voice on the other side of the water made some announcements, and suddenly they were off, speeding around and around orange buoys making fantastic noise. There were other "extreme" sports demos, including BMX bikes, logo stick artists, and water acrobats.

After that race was over, we went to investigate a very loud BOOM. It turned out to be an eighteenth-century canon. The officer in the front explained what good men were doing, but he delayed so long that I was surprised when the thing went off again and didn't get a photograph.

Next up was this enormous sand sculpture under a protective tent. It is a greater-than-lifesize montage of everything "Pittsburgh," from steel bridges to Mr. Rogers, Heinz 57 to the Pirates. We learned that the first Ferris wheel was constructed north of the city for the 1893 Chicago World's Fair. The ferris wheel at the Regatta was 90 feet tall. This one was 264 feet tall and cost $0.50 to ride--the equivalent of $90 today.

At this point we had exhausted our curiosity, and my left knee was really talking to me, so we parted ways with JP and headed off to a BBQ. It occurred to me that our visit to the Regatta was not unlike those of my historical subjects attending fairs in Germany in the early twentieth century. Some people may in fact have come out because they are fans of boat racing (or nutrition), but most probably came out of curiosity, boredom, and--at least for the charity race--a sense of schadenfreude. Attending the Regatta was a nice (free) way to spend a summer afternoon and learn a little bit about Pittsburgh history and culture.

Here we are at the Point, where the Allegheny and Monongahela Rivers come together to make the Ohio River.

Tuesday, August 2, 2016

What Internship Looks Like XI: Parking Garage Woes

Sometimes what internship looks like is the premise of a bad B movie. Dude, I parked my car 14 hours ago, and I just changed the license plate, so I think I actually walked by it the first time.