Learning Life Lessons: An Oncologist Shares His Story

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Breast Cancer

Dr. Robert HegemanRobert Hegeman, MD, (pictured left), oncologist with the UW Carbone Cancer Center shares his personal story of how he is grateful for the difference his patients make in his life.


She always dressed neatly and was relentlessly optimistic. Her family was wonderful and supportive. She had an aggressive breast cancer that began small and seemed initially to be cured with surgery. We discussed the possibility of chemotherapy to reduce the chance of the cancer returning, but she refused, on the grounds that the summer was coming and she needed to take care of her garden. She wanted to taste the sweet corn and tomatoes free from any distortion of her tastebuds. 


She unfortunately recurred by the early autumn of that year. The leg weakness she'd developed over Labor Day weekend was due to a large mass that compressed her spinal cord, and there were numerous other metastatic lesions. 


I've grown accustomed to breaking bad news to patients, but walking into her hospital room I had a particularly difficult time. I remember shaking hands with her husband, who I knew from clinic visits, and they introduced their many children and grandchildren. She wanted them all to be present for my visit. As I stammered my way through the facts, she smiled and nodded knowingly. She asked very few questions.


"I've been expecting this," she reassured me. I'd been holding her hand, but it was she who squeezed mine tightly, and looked directly in my eyes, in a comforting way. "It's not your fault, doctor."  


She then distracted me, and her family, with a hilarious tale from her childhood involving their town doctor, a few too many drinks, and a cowpie.   


She ultimately agreed to radiation, and chemotherapy, and tolerated them well. She was able to walk again, and busied herself with making pies, jams and jellies, many of which she brought to her appointments for the clinic staff and me. 


By the spring, though, she was losing weight and feeling weaker. The scans showed what we feared, that the cancer was growing again. She informed me that she'd had enough of chemotherapy, despite the chance that a change in medication would temporarily turn things around. She wanted to try fresh air and sunshine, and remained steadfast in the face of my scientific reasoning about response rates and textbook options.  


Against all odds, she did well for quite a while longer than anyone could have predicted. At the end, she was graceful as always, and died surrounded by family. Her bravery and optimism, despite the difficult hand she was dealt, stick with me.  


In addition to teaching me to have a little skepticism about statistics, she taught me something even more important - to appreciate my life. Whenever I begin to feel sorry for myself for such minor things as: A tough day at work, or the weather, or waking up for the tenth time in one night for one of my kids, I try to stop and think about things differently. Now, it doesn't ALWAYS work, but I believe it has made me a better physician, and I know it's made me a better person.