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Not Really Congratulations

Posted 10/8/2015

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  This is the second entry of the day because I will be traveling much of tomorrow, and because this is fresh in my mind. This morning I had an appointment at the Travel Clinic in preparation for an upcoming trip. The lovely NP looked over my history and asked whether I was still doing well post breast cancer. I said: "Thankfully,yes." She said: "Congratulations."

  I was shocked and dumb-struck, knew this absolutely was an example of someone trying to say the nice thing. And it was totally the wrong thing to say! Congratulations!!? For what? For being lucky? For being lucky to have been born in the US in the 20th century, for being lucky to have had access to wonderful cancer care, for having apparently (trying not to jinx things here) had cancer cells that responded/died when faced with the chemotherapy drugs and the ongoing estrogen suppression? None of those had anything to do with my skills or determination, and everything to do with luck.

  I said something like that in response, and we moved along. But it has stayed with me all day. How many people think, at some level, that patients really should be congratulated for doing well because they have done something to make it happen? I don't think this was true for this particular young woman, but I imagine that there are others who do believe that how we handle it or how brave we are or something makes the difference. It's biology. Not anything we do or don't do. (assuming that we show up for treatments and do what our doctors suggest)

  And, most importantly, what does congratulating me suggest about all my beloved patients/friends who did absolutely everything that they could to stay well, fought so hard, prayed intently, ate right and exercised when they could and loved their families and their lives...and died. What about them?

 And what should we be thinking about them? I have had a conversation this week with Cynthia about a friend, Carol, whom she met a number of years ago in one of my support groups. Carol died recently, and the third close friend in their trio, Paula, died a couple of years ago. Cynthia and I talked about sadness and loss and survivor's guilt and our shared feeling that the best way to honor them, and too many others, is to live the very best lives that we can. With gratitude, not with congratulations.

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