Pediatric oncology is one of the most difficult fields in medicine. Every time I get that call, my stomach drops. I know I’m the physician parents hope they never have to see.
My primary focus is solid tumors. These can be challenging and, unfortunately, we don’t save all the children. My approach is honesty tempered by optimism. I am a glass-half-full person, but I’m not going to give false hope.
In that first shocking conversation, I have upended the parents’ lives. I’ve told them their beloved child has cancer. They’re probably going to hear only a small percentage of what I have to say.
I used to fill those conversations with details—things they weren’t going to remember. But talking to families later, they recall me saying: “We are going to treat this, and we are going to give it our all.”
Now I steer away from the minutiae. I promise that our treatment team is committed to them and we’re going to answer all of their questions. My job is to give them as much peace as I can. The hard part is knowing I can only give each family so much time.
Unfortunately, there are diagnoses when, despite our best attempts, the chances of a cure are small. I paint the picture that it’s going to be difficult, but we’re going to provide the very best care we can. I try not to downplay the risks of certain cancers or chemotherapy. These are toxic drugs I’m giving their child. There are times I lie awake at night. I’m very aware my decisions have real consequences.
I don’t believe in the adage “Physicians don’t cry.” I do cry, and families have seen me cry.
I got into this field because I truly care for my patients. Sometimes we don’t get the outcomes we want. Tumors don’t always behave by the textbooks. I have my own children at home. That balance is always difficult for me.
I celebrate the wins; I celebrate the end of therapy or when a patient gets a Make-a-Wish trip. But when things don’t go the way we’d hoped—the cancer comes back or we’re out of treatment options—I grieve with them. I don’t think I could do this job if I didn’t let myself openly feel emotions.
As far back as I can remember, I always wanted to be a physician. My grandmother told me from a young age that she knew I was going to become an amazing doctor. I work hard to live up to her expectations.
My patients are incredibly brave, incredibly strong. They inspire me. I have an amazing family, a wonderfully supportive husband and parents, great kids, great partners at work. Rady Children’s Hospital is an amazing place. I feel blessed.
A Pediatric Oncologist on What Cancer Means to the Whole Family
Photo by Priscilla Iezzi
