I entered the Jewish General hospital, past the clinic where I used to work, heading towards the radiation suite. It was strange to come back after 8 years away, and to walk in as a patient instead of a doctor. Five people stopped me as I walked down the hall. “Oh you’re back! Can I be your patient again?” I smiled and was noncommittal. Would I ever see patients again?
My first five years living in Toronto were the best of times.
I was working as the director of the family medicine teaching program at a large community hospital, a job I had long coveted. The chief of my department was a kind and brilliant man. He was married to one of the most prominent Family Medicine researchers in the country, so I was pretty sure that he was not intimidated by smart women. He was also a fiery lead guitarist in a semi-pro rock band. I was gifted with an intelligent and devoted program assistant, Maria, whose administrative skills compensated for my ADD.
At UofT, I was invited to be part of a national committee that created the standards for medical education in Canada, known as CanMeds. I then helped translate these principles into actionable “competencies” which outlined what people needed to know and be able to do to be a good doctor. You would think that’s obvious but it’s not. I had a talent, it seemed, for making things practical. I was then invited to go to Brazil, with a small group from UofT, to help the Brazilians create their own competency curriculum. I was having so much fun!
I loved teaching the residents and organizing their program. They liked my teaching as well and they thought that my purple hair was cool. They liked how I was there for each of them when their lives were hard, when they had conflicts with preceptors, unexpected pregnancies, or failed rotations. They appreciated my tough love approach to family medicine teaching. They knew that Maria and I would struggle to give each of them the best possible residency experience. They also loved the parties we had at Christmas, where I encouraged them to create satirical skits. Somehow, they always chose to roast me. One featured a video of one of the male residents as a drag version of me, with enormous balloon boobs, purple hair, quoting “Perle’s Pearls” while eating handfuls of raw vegetables. I too felt like a rock star. They saw me.
Then things fell apart.
The administration changed, and my champions were replaced by people who were much less charmed by my line of chat. I felt suddenly politically isolated.
The real problem though was that my family was not doing well. My father was becoming more demented every day. My mother was worn out caring for him. Then my father died, and the day we got up from Shiva my sister found the lump that turned out to be cancer. A complication of chemotherapy which had a 50/50 chance of death put her in hospital. Soon after she came out of hospital our mother was diagnosed with lung cancer, and she died just a few months later.
I should have taken medical leave when all this started, but I hung on. I was too proud to admit that I couldn’t cope. There was no one there whom I trusted to confide in, and no one to ask me why I was not myself. No one seeing what was happening to me. I was snappy, lost my temper often, yelled at my staff with frustration when things went wrong. Maria took the brunt of my dysfunction, and I could see her respect and esteem dwindling, but somehow, I couldn’t stop myself. I was disrespectful at meetings and really childish. Unsurprisingly, they terminated my contract. For the next 2 years my friend Alan took me into his clinic, saving me from total humiliation, but I felt diminished.
Then I attended a medical education conference in Montreal. While in town, I realized that my children there were also having hard times and that they needed me, a fact I was oblivious to, because I was far away and mired in my own misery. I needed to come home!
Then I ran into my former resident, Marion, who was now the program director. “I wish you were here” she said, “we are creating our competency curriculum, and we could really use your expertise!”
It was like a ray of sunshine piercing through the clouds. “Make me an offer,” I said.
Half an hour later my old friend Vania was at my side with a job offer. It was so good to be seen and wanted.
Before I left Toronto I thought “I might as well get my mammogram done”. When the radiologist came into the room and wanted to do an immediate ultrasound, I knew what was up.
Six weeks after surgery, I met the Radiation Oncologist in Montreal. He was not impressed by the fancy genetic testing done in Toronto that said my tumour was low risk and needed no chemo. He was going to make sure that there was no cancer left and “sterilize the breast.” The treatment was gruelling! The Rad Onc fried me so hard that my skin fell off and I had wounds on my back. You never want a radiation nurse to say, “Oh my God!” when she takes your shirt off, but she did. As I looked at myself in the mirror, looking at my oozing breast, I really saw myself as I was. I had let things go too far. I had lived in a state of denial, willfully not seeing what I was doing to harm those around me. I finally owned what I had done to harm my children, my colleagues and myself. Slowly the burns healed, my heart healed, my relationships with my children healed, I was able to go back to work and heal other people and teach again. I learned that I didn’t always have to tough it out, that sometimes quitting is the right thing to do.
I was left scarred, but still strong. I am happy.