Angela Gutierrez, M2, Class of 2026
I envision this as the captivating genesis of any HPI, or like the opening scene of a
standard case presentation, or when preparing ourselves for the narrative of a vignette leading to
a thought-provoking question. Fictional patients based on real people. However, unlike these
fictional patients, this is real. This is mine.
In October of 2020 I was diagnosed with stage 2 Invasive Ductal Carcinoma (ironically
during breast cancer awareness month). This was also during the time of a pandemic which came
with its own unique challenges. I was in the midst of my medical school applications, when I
heard the tip of the iceberg “I feel a lump”. This was followed by an appointment with my
primary care physician who swore it was just a cyst, but sent me off to imaging just to be sure.
An image turned into a biopsy, and a biopsy turned into a diagnosis. This would be a piece about
my cancer experience, like how I found out pain meds don’t work on me during my painful
biopsies, or how I had an anaphylactic reaction during my first chemo infusion, or maybe how
my skin started to melt off from my radiation treatments. However, I think a lot of us know the
gist of the cancer experience. But what about the aftermath?
The lingering aftermath of cancer is a topic often left unspoken, a realm rarely explored
in conversation. How “survivor” doesn’t really feel like an end-goal, but a placeholder. Your life
becomes consumed by numbers. Stage number, prognosis percent, 5 year survival rate, etc.
People give their support and love until enough time has passed to resume making cancer jokes. I
have a growing list in my phone for every cancer joke referenced in movies/tv and so far I’m at
34. That doesn’t seem like a lot until you realize how little time you spend watching those apart
from studying. I hate cancer jokes.
The profound internal struggle arises from processes of desensitization experienced while
navigating the dual roles of both cancer patient and medical student. We always talk about
cancer, and in a way it helps you separate from it. However, each case is a reflection, a reminder,
of a part of you. How does one navigate when a patient dies from metastasis while
simultaneously reassuring oneself that such an outcome is not a possibility? “No, that’s not
going to happen to you!” Why wouldn’t it? I am no different than thousands of people who get
diagnosed everyday. I’m just another number. Each ache, bruise, and pain becomes magnified
and I wonder whether these sensations are harbingers of a potential recurrence.
It’s eerie to talk and learn about something that has caused you so much grief. How the
patient’s experience can be summed up in a page. But to you, it’s a whole series. How the
treatments you talk about, is the same little white pill you take every morning for the next 10
years. Or the therapy referral you make, to help the patient when they develop PTSD, anxiety,
and depression.
I wish I had a resolution, but that’s not reality. I will continue identifying with both
patient and physician. When I tell this story, people always want a silver-lining. “Maybe this
experience has shown you how to have compassion for your future patients”. I’ve always
embraced compassion and care as my strengths. Truth is, sometimes unfortunate things happen.
Not to good people or to bad people, they just do. I hope as medicine develops, the cancer stigma
will soften. That people won’t have to carry it as part of their identity. That people won’t have to
have survived “the biggest battle”. That we can reassure them that this can be overcome. That’s
not to diminish the hardships of cancer treatment. Believe me, they’re hard. However, it’s crucial
to highlight that this constitutes just a fragment of their narrative, not the entirety of the book.
I encourage you to employ empathy to “A 24y/o F”. They are more than just a descriptor,
they are more than a diagnosis and treatment. They are someone coming to you with a
vulnerability. Recognize that with humility. Situations like this go beyond the 4 walls of a
doctor’s room. There will be lasting scars. What an honor it is for you to be a part of their team.
Med Intima 