4 years and still kicking (& being kicked)

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Initial chest x-ray in the emergency department

Another day trip to Sydney, this time to Bondi. It would be great if I was going to “Sculpture by the Sea”, but no. Yet another medical appointment. Today marks 4 years since my health started unravelling. Living with cancer is tough. You often hear it described as a “battle”, however many don’t like that term as it infers that if you lose the battle you weren’t fighting hard enough. Those that do survive, must’ve fought harder. In my case I don’t think the analogy works anyway because the last few years has been a pretty passive process for me. Things being done *to* me rather than *by* me. It’s often felt like I’m just curled up in a ball while cancer kicks me repeatedly. Occasionally it, or perhaps more accurately, the treatment side-effects, seem to get bored and leave me alone for a little bit and I can catch my breath. But when I do try to get up & do something, I get whacked from behind again and I’m back on the ground.

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Lateral chest x-ray from ED

However, despite this frustrating and oftentimes painful cycle over the last 4 years, I have also been able to see how genuine good can come despite, and even from, deep personal pain and suffering. And not just for me personally through a changed outlook on life and new opportunities, but also seeing the good in the many family, friends, colleagues, scientists and healthcare workers that have helped and supported me over that period (too many to name, but you know who you are!). But this raises an important question for me. Perhaps an unfortunate by-product of huge advances in medical science and other fields over the last 50-100 years, which have played a big part in me still being alive today, is that many in the west, including myself (despite being a doctor!), are surprised by suffering. We can go so long these days without having to ever confront it head on in any personal or existential way. At the slightest hint of trouble, there are so many quick fixes available to us that we can find a way to avoid even the potential for discomfort, pain or suffering. This might work in the short term, for us as individuals anyway, but i think it has the potential for wide ranging, longer term, unintended consequences. It can mean that we, and those around us, aren’t as well equipped to process or deal with genuine suffering when it does inevitably come.

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First brain MRI showing the metastases

Lack of exposure to minor setbacks & suffering, or reduced opportunities to support those around us in their times of suffering, mean we haven’t developed the mental resilience that can prove so beneficial when we are inevitably faced with more severe and permanent setbacks. Our families and friends are in a similar boat, so they may not have a framework to help us through difficult times. It also makes me wonder what good things we might be missing out on due to our risk aversion and because of our assumption that no good can come from suffering. And are are we just perpetuating the problem? Making it harder to have genuine conversations about how we are really feeling, because we don’t want to burden others with the pain and suffering that we are experiencing? So we internalise it, not only making it worse for ourselves, but probably, ultimately, worse for those around us who we love and care about, and are trying to protect.

Lateral MRI with different settings which highlights the swelling around the tumours

There are no easy answers here. I think we should try and relieve pain and suffering wherever we can, but i do think we also need to try and re-frame the discussion and consider what opportunity costs and possible downsides there are to some aspects of our current approaches. We should realise that, ultimately, pain and suffering is a universal human experience, no matter how much we try to avoid it. We need to consider, as a society and as individuals, how are we are going to approach it? What can we learn from it? How can we grow from it? How we can we share genuinely from our own experience of it? And perhaps most importantly, how can we best help those that are in the midst of it?

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