Sorry/Grateful

About five years ago, shortly after I finished all of my original treatment, I was asked to speak to a group of medical students about my experience as a breast-cancer patient. I was one of three panelists, each of whom represented a different demographic. I was the "young" patient.

The first thing I said to this group of a hundred or more students was, "A good doctor saved my life."

I said it a second time, for emphasis.

A good doctor saved my life.

And then I proceeded to tell them about my gynecologist. She had been my doctor since December 1988, except for the three years that we lived in California, so she knew me well.

Every time she examined me, at least once and sometimes twice a year, she took careful notes. In January 2001, I was seeing her again for the first time since we had moved back to New York two months before. This time, when she did the exam, she noticed a subtle difference between my otherwise identical breasts.

She looked back at all of the previous exam notes she'd taken over the years. None of them reflected any kind of asymmetry.

And that was it. That's what prompted her to send me for a mammogram, despite the fact that I was a year away from the recommended age. And that's what ultimately led to my initial diagnosis, and then to my revised diagnosis, and then to all of my treatment, and then to almost four cancer-free years.

If she hadn't paid close attention during that exam, and every other exam she'd ever given me—well, I don't like to think about that.

But she did.

More than one other doctor subsequently marveled at the fact that my gynecologist had detected anything at all. In fact, she didn't even know what she had detected. She wasn't even worried about it. She just knew it was something that should be checked out, even if the odds were overwhelming that it would turn out to be nothing.

She didn't take a chance. And that meant I had every chance.

I saw my gynecologist today for a routine check-up. At the end of the visit, as she was leaving the exam room so that I could get dressed, it occurred to me that I hadn't thanked her often enough. I started to tell her that—that I hadn't thanked her often enough—but I immediately got choked up.

I'm sure I caught her by surprise. We had been having this lighthearted conversation up until then, and suddenly I had gotten all serious, and then I had gotten all teary.

I suppose it is awkward to be acknowledged for saving someone's life, especially six years after the fact, because she gave me a self-effacing sort of a smile and then waved me off and backed her way out of the room.

I know that some of that awkwardness stems from the fact that despite her clinical skill, despite the subtlety of the finding, she still could not spare me from this disease. I know this because we had a long talk after my first diagnosis, when I was second-guessing my doctor in California for not detecting the cancer sooner, even though it had almost certainly been undetectable six months earlier, when I'd seen him last. We talked about how natural it was to try to find an explanation for the unexplainable, to try to find someone who was to blame.

It was then that she confessed that she'd been unable to forgive herself for not finding the cancer during the three years I had been in California. It was a completely irrational thought, and she knew it—not only hadn't the cancer been detectable, I hadn't even been back to see her in all that time—but it haunted her nonetheless.

I can only imagine how she felt when I told her about the second diagnosis a year ago.

It is a strange thing to be grateful to someone who feels guilty about the very thing you are grateful for. But it is so hard to make sense of any of this, really. Sometimes I think it is foolish even to try.