I'm a doctor and I have cancer
In a new column, Dr. Nikhil Joshi details his journey through cancer treatment
How the hell did I wind up doing this? I think to myself.
I'm staring at an 18-gauge needle, filled with a potent medication called Neupogen. It's going to stimulate my bone marrow to put out more cells to fight infection. I have to take it because the chemotherapy damages my immune system.
I'm on chemotherapy because I have cancer. I'm 27, and I'm a physician training in internal medicine. Three months ago, I was only concerned with how many exhausting hours of call I had to do in a week.
But I had been keeping an eye on this swelling on the left side of my neck. It just seemed bigger to me than it should be. When you're a doctor, you're always worried you have cancer.
Then, one day I'm just being my paranoid self and feeling my neck and I notice the left side of my neck is bigger, and there are a few other large nodes there.
Lumpy necks are usually nothing. You can get lumps when you're sick or if you've had a viral infection. But I hadn't been sick for months, and I had no flu-like symptoms. I just had this thing in my neck, and this feeling in my stomach.
"Dad, feel this," I say.
My father has been a physician for 36 years. He has one feel of my neck. Then his face goes ashen.
"How long has this been there?" he asks.
"Somewhere between three and six months."
"Three and six months!"
"God. Yeah. I just thought it was a reactive lymph node."
"For six months?!"
"Nik, the only reason I'm telling you this is because the last time I felt something like this the guy had lymphoma."
I went silent. Lymphoma is a type of cancer. I could have cancer.
A visit to my family doctor, a referral to a hematologist, and a painful biopsy to the neck later and ding ding ding, I have cancer. Hodgkin's lymphoma. Stage 2A. Chemotherapy to begin immediately.
The next thing I know, I have a permanent IV line in my arm, sitting in the chemotherapy suite at the Health Science Centre in St. John's and I'm wondering if this cocktail of drugs hanging next to me will save my life or leave me breathless and infertile.
Injections and hair loss
It's hard to believe that all that happened about two months ago. I take a deep breath. I need to be here right now.
I fully snap out of the past and my own head as the needle enters my skin.
Now is the hard part. I inject the substance into my body. It burns and hurts, and I don't want to do it. I want to stop and pull it out. Instead, I breathe, curse quietly and finish the injection. I pull out the needle and slap an alcohol swab over the entry point. The pain of the needle subsides, but in a few minutes, I'll start to sweat and have bone pain.
I down some Tylenol and make my way upstairs, where I go to the computer to write all this down.
The computer keyboard looks like a black dog just shed over it. That's my hair. Thank you, chemo. As if being five-foot-five and having cancer isn't bad enough for my love life, I'm losing my hair.
Why I'm doing this
I'm not sure why I'm telling you all this.
The only thing I can figure is that cancer is this huge topic and it's usually handled so dramatically. Some people make it out to be a Rocky-style fight, others approach it as this wonderful Eat, Pray Love-style experience, or they find themselves in a staring contest with the Grim Reaper, puking their guts out, and waiting to die.
The truth is, cancer is kind of all those things, and also, kind of none of them.
I think I want to try to make it easier for people who have cancer and people who know people with cancer to understand each other a bit better.
Maybe I just want people to understand me a bit better. Right now, that's all I've got.