How an Emergency Physician Learned to Embrace Fear

As a 5-year-old child, I had a terrible experience lasting several hours, during which I remember thinking that I should just let the people involved kill me, because the torture of letting them hurt me and of knowing that they would likely kill me, was worse than dying.

This theme, of trying to survive torture, knowing I should just give in to death, still haunts my dreams nightly.

In hindsight, I suspect this experience and the general environment leading to it shaped my life and career in a very big way. Without knowing it, I learned to embrace fear. I became fierce, strong, and resilient.

I am an emergency physician and have spent an entire career on the “control end” of trauma, grief, and the worst days of my patients’ lives. I worked in busy inner-city Emergency Departments seeing the worst of society’s woes reflected in individuals. I’ve heard the unforgettable, indescribable wail of a mother being told her child is dead, more times than I care to count. I have helped pluck people from the brink of death more times than I can count. I have cried in front of patients and families. I have been sent a handful of letters over my career thanking me for being the “angel” in that family’s life.

Being on the “control end” gave me a false sense of security that I really was in control. But deep down, I was always scared. Because somewhere, in the back of my heart, I knew that my sense of control was an illusion. Control is the Great and Powerful Oz. In the end, there is a vulnerable, powerless little person behind the curtain and life can turn on a dime.

I feel the great privilege of my last 4 years of life which have taught me to embrace fear and not be afraid. NOT AFRAID. At all. My method to embrace fear might seem morbid, but please hear me out.

In November 2015, my son was diagnosed with an incredibly rare form of bone cancer, Adamantinoma. At the time of his diagnosis, there were fewer than 600 people in the history of the world who had ever been diagnosed with this cancer. There are no protocols, and other than surgery, there is no treatment. No one is going to study such a rare cancer– it isn’t worth the money on a societal level- I get it. So, if his cancer recurs, he dies.

In June 2017, while my son was still recovering from multiple surgeries for his cancer, I was diagnosed with early-stage, but very aggressive breast cancer.

I had surgery, chemo, and radiation. My metastatic recurrence rate is much higher than I would like it to be for having gone through the treatment that I went through. This means that I have a larger chance than most early-stage cancer survivors of having my cancer return. I tell you this to set the stage for why I’m not scared. To set the stage for why, despite it sucking to have cancer while also having a son with cancer, I am thankful for the lessons cancer delivered.

Cancer’s lessons have freed me from my lifelong cage of fear and from the illusion that I have control.

The lessons cancer has taught me have allowed me to live a better life for however long I have. I have never in my life, despite the uncertainty, been LESS afraid. I embrace fear and I feel gratitude for cancer’s lessons each day.

So, what are cancer’s lessons?

• • • I can do everything right and I can still die (or one of my kids can die) at any time
    • All I can do is all I can do. Read that again
    • I only control my own actions and thoughts
    • I want to be happy and experience joy while living in the reality of whatever it is my day holds- good OR bad. This holds true in sickness and health
    • My joy is my responsibility to create. If I want it, I have the power to make it, as long as I accept the reality of my situation
    • Today (right this second) is all we have- so live it
    • Worrying about anything happening in the future ruins my life right this second

I am super stubborn and fear is my enemy. Fear either steals my time or makes the time I have less satisfying.

Additionally, living in fear lowers my immune response and makes me MORE likely to get sick.

I refuse to aid the enemy. Cancer has snatched and may continue to snatch, many things from me that I will never get back. However, I REFUSE to hand over anything that wasn’t snatched directly from my hands. My psyche is one of those things I’m holding on to. No way am I letting that go. I’m not playing into the hands of the enemy. I will live my life to the fullest until I stop being conscious. I will embrace fear.

This does not mean that I don’t experience emotions like fear, grief, and rage. I feel sadness when things are sad. I feel physical pain, I feel loneliness, I feel disappointment. I cry when faced with losses.

But, I know that these feelings can co-exist with joy and beauty. I embrace fear and I allow myself to live in duplicity every day. I take time to focus on things that bring me joy.

An analogy I can make is this:

I am in a pitch-black room holding a single flashlight.

In that room is something horrible and scary and also something wonderful and joyous. I know they are both there.

I have a choice.

I can continuously shine my flashlight on the horrible scary thing to keep an eye on it at all times so that I can see it approaching me (note: I have no weapon if it does approach, only a flashlight), OR I can shine my light on the thing that brings me joy most of the time, occasionally shining it on the bad thing, just to see if it’s still there (it always is), then shine it back on the beautiful thing and live with that, knowing the bad thing is always there, always will be there, and may do me in at some point, but until it does, I choose to look at the joy.

One of the interesting things, when you have cancer or have a child with cancer, is that in order to make you feel better, friends and family offer platitudes of “I know you will kick its butt,” meaning that you (or your child) will remain cancer-free.

To me, the kicking butt comes not from your disease status, but from your willingness to be ok and to find joy in whatever the physical outcome of your situation may be.

Live in the reality of any possible outcome and find joy in what there is to be joyful for.

By refusing to accept that bad outcomes are a possibility we bring ourselves pain, fear, and suffering. My goal is zen acceptance of all possible outcomes, good and bad. I want to find peace with all outcomes and create my best life within those confines. If I start to die, or if my child (or children) starts to die, or if my partner starts to die, I will work to live the heck out of that experience.

This is what it means to embrace fear.

I have learned that during hard times, there are many precious jewels buried in the pile of garbage that we have to shovel through. You always have the choice to be on the lookout for the jewels, to reach down into the garbage pile, pick out the jewels, polish them off, and revel in them, or just keep shoveling garbage. The choice is up to you. I know what I choose.

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