My health continues to be good. Unfortunately due to the chronic, unpredictable, and ultimately terminal nature of metastatic breast cancer, feeling healthy one day doesn’t guarantee anything about the next day and for that reason I have decided to take a step back from my job and am currently enjoying a more laid back existence. I knew this day would come four years ago when I was originally diagnosed as metastatic and I had hoped that it would come early enough in my diagnosis for me to continue a high quality of life and that I would feel at peace with my decision. As one of my former oncologists said “It’s hard to know when to say when”. I cannot say I am totally at peace with my decision, some degree of embarrassment and shame still lurk, but I can honestly say I feel better and better about the decision each day.
Multiple factors are at play when a woman of my age, with my family life, and my work situation gets an unpredictable, ultimately terminal diagnosis. Side note: If you are wondering why I would throw around the word terminal when I’m obviously not packing my bags for hospice, there is an article you can find here, written by Abigail Johnston, a fellow metastatic breast cancer patient who writes a great blog about life with metastatic breast cancer. Mentally and emotionally I immediately went to a place of panic about having a much smaller number of years left of this earth than I had planned for. This led to a sudden disinterest in going to work. I couldn’t shake the vision of continuing to burn myself out at work only to get massively and dramatically sick for a few months, then die. The second and probably most significant factor at play was simply the issue of time and lack of ability to schedule all of the necessary appointments around my fairly inflexible job. One of the most important attributes of a nuclear pharmacist is the ability to show up. There are no “substitutes”, there is no “save for tomorrow”. You need to get a short-lived product out to hospitals STAT and there is literally almost no one else trained to do your job. For me to schedule an appointment meant taking a day off months in advance. There is no calling in sick. That would literally be asking my co-worker to work a double shift at the last minute. Finally, the combination of full-time work commitments and kids pretty much maxes a person out, there is little to no room for other demands. I tend to beat myself up for this, but given the expectations we all put on ourselves, very few people are equipped to take on a serious medical condition (or for that matter any number of life-changing events, death of a loved one, divorce, job loss; whatever it might be). We don’t give ourselves much wiggle room in this society, we run ourselves pretty ragged. What I noticed happening on a regular basis was that the variable constantly getting cut out of my life was my kids. Because I am blessed with lots of help from both my family and my husband’s family, time with my kids was the easiest thing for me to carve out of my schedule and became the go-to way to solve the ever-present problem of timing/scheduling issues. This is tricky as a parent. My kids love their grandparents and aunts and vice-versa. My kids get great care from extended family. My husband is also a very present father to them and helps immensely. By all accounts, everyone was doing great, if not even better than if I was always available to my kids. But I had reached a point where I just couldn’t do it anymore. The combination of pandemic life and my lung infection last year probably accelerated those feelings. The anxiety of scheduling appointments and feeling under the weather all came to a head in the fall of 2020. The kids started the school year virtually (and continued that way until April 2021) at the same time I was spending literally 10 hours a week at the hospital trying to start a clinical trial and then trying to re-diagnose a painful abscess in my ribcage. It was taking well beyond too much of my time and energy just to manage my job and health condition. There were several instances where I literally had to be three places at once. I think I would have tried to just “tough it out” if 1) I weren’t diagnosed with a condition that requires I undergo active treatment for likely the rest of my life, active treatment that causes issues like the lung infection I suffered last year and 2) I wasn’t diagnosed with a condition that as we know it right now will likely take my life within the next ten years. At the expense of seeming like I’m being melodramatic or feeling sorry for myself, these are the facts and the time had come to make a decision of how to manage the cards I’ve been dealt.
The two things that have really thrown me for a loop with this decision were the reactions of others and the reactions from my kids. I have not kept my diagnosis private. I feel like if anything I error on the side of being too open about my health and I fear I’m coming off as too melodramatic and self-centered when I write or talk to people about my health. Unfortunately, the most logical question that comes up when I tell people I am not working at the moment, “What are you going to do?” is the one that for some reason I was totally unprepared for. Of course people are going to ask that, makes total sense. But in my head I’m always thinking… “What do you mean, ‘What am I going to do?’?!? Have cancer and have a family. That’s PLENTY for me!” Then, in the beginning at least, my mind would start to go down the dark rabbit hole of wondering if I am lazy, worthless, uninspired. I’m getting a lot better with that question and honestly, I realized pretty early on that a big part of why people have this reaction is the way that I tell them the news. I appear healthy, haven’t said anything about the cancer in a while, and am generally just saying it casually as one would when they are just looking for a new job or making a life change. I was discussing my wonderment at different reactions to my news with a friend who left the medical field for similar reasons. She passed along some wise words from a health psychologist: When you share this news, people are going have all sorts of different reactions and for the most part it’s a reflection of their relationship with working in general, not some sort of judgement on your life choices. I think this is really good advice and I bet it applies to many other life decisions (having children, raising children, medical decisions and treatment, financial decisions….really everything).
As much as I tried to prepare my marriage for this big life change, I completely overlooked the reaction and feelings my kids might have. I was really nervous about how quitting my job might affect my relationship with my husband. In my 16 ½ years of knowing him, I have never been unemployed. For a variety of reasons (probably my own mental health as much as money) it has always been a priority for him to keep me working and he has always gone above and beyond helping out with housework and the kids to make that happen. Like most couples, money is always a potential source of conflict with us also and so I feel I overcommunicated with him and was overcautious as I made this decision. With my kids, however, I just took for granted that they would be either unchanged or if anything happier. I guess I assumed I would be a better mom, more present, and able to provide a more stable environment by not working and of course they would just accept it and be happy. I completely overlooked 1) the fact that my identity to them was a working mom and 2) they also have concerns about money. I guess I just lumped all of my stress and frustrations of being a working mom in together with their stress and frustrations and assumed life would be easier for all of us if this working piece was out of the puzzle. But truth be told, I think from their perspective, having a parent suddenly not have a job is just as much of an adjustment as having a parent suddenly start working. And I totally dropped the ball when thinking these things through from their perspective and preparing them.
I think what really scared me about the possibility of leaving my job was the confidence and self-worth that it gave me. Recently, in People magazine, Kenny G (Yes, the 65-year-old 1990’s saxophone-sensation/popstar Kenny G and yes, the magazine was dated February 4, 2022, and yes, I realize the fact that I’m reading Kenny G articles in People magazine is not a great look, and yes, he still looks like the amazing curly-haired, chisel-faced heartthrob he always has. I’m not sure what skin and hair products he uses, but he should promote them.) stated: “Getting good at something will give you a lot of confidence.” Simple enough, but I think this comment states what my job provided to my life in a nutshell. I was good at my job. I had confidence that bled into other areas of my life. If ever I was feeling unsettled or bad about the way another part of my life was going, I always had my work life to fall back on. At the back of my mind, I could always resort to: well…they should see me at work, I am an invaluable team player and I make a difference in my workplace. And herein lies the issue, I am not an innately self-confident person. I am cautious and timid and question myself excessively. Experience and expertise in a setting, like my job, is huge for me and where another person might be able to “fake it til you make it” or even gain this level of confidence in a short time, it will take me years of work and experience in a role to feel comfortable.
As I start my journey in this new adventure, I am pleasantly surprised that I don’t feel as worthless as I thought I might have. While that is definitely a positive, one struggle that I have is the movement into more of a gray space of life. I do not do well with soft skills, I function best in the black and white. With my job, I enjoyed defined expectations, metrics with a “gold star” at the end. While we all need to manage the nuances of communication and relationships in any job, I feel my job allowed me to perform in a space above a lot of that. Are you putting out product, making money, keeping customers and coworkers happy? Yes or no, easy. On the other hand, as a parent, wife, daughter, sister, friend, and volunteer, the judgment is much stickier. I have never in my life felt like I was performing well in any of those jobs. Another aspect of this gray space is that now I am charged with being completely responsible for every minute of my day. With a job, you just go to work. It can be really hard and frustrating, but it is planned for you. Moving to being unemployed, I now have full control over how I spend my time. Stressed, frustrated, burnt out? Umm, that’s on me now. Of course anything medical was not my choice and is still out of my control, thus circling back to this whole big life decision, but I am slowly adjusting to all of this space and it is definitely a winding road adjustment.
Fortunately, the feeling that consistently bubbles its way to the surface, no matter how “in my head” I get, is gratitude. I realize I am fortunate to be in a position to be able to make a decision about my employment at all. And to be able to take a step back while I am still feeling healthy and increasingly optimistic about my chances to hang on until some really good treatments become mainstream is truly a blessing. I may not appreciate and cherish it everyday the way I probably should, but I ultimately realize that I am lucky and have been given a gift of time that I will never take for granted.