Doc Discussions with Dr. Jason Edwards
THIS is the podcast you have been looking for! "Doc Discussions" are just what the title says they are: physicians from a wide range of specialties, talking about relevant, up-to-date medical topics, not to mention tips on habits to help you live your best life. Your host, Jason Edwards, MD, is a board-certified radiation oncologist with a PhD in cellular and integrative physiology at St. Luke's Hospital in St. Louis, Missouri. Dr. Edwards explores not only diseases but also suggests techniques to optimize mental and physical health for a long and good life. Real people. Real advice. Real good. This is Doc Discussions, with Dr. Jason Edwards!
Doc Discussions with Dr. Jason Edwards
When The Healer Becomes The Patient: A Doctor Faces Lymphoma
A lump discovered while shaving during a ski trip turned Dr. Julie Gould's world upside down. As an obstetrician who prided herself on healthy living—never microwaving plastics, exercising regularly, getting routine checkups—she never expected to face follicular lymphoma. "I'm the one who's going to live forever," she thought, making her cancer diagnosis all the more shocking.
Dr. Gould takes us through her journey from initial discovery through diagnosis, treatment decisions, and the profound ways cancer changed her outlook on life. With remarkable candor, she shares the surreal experience of creating a "funeral playlist" the night of her diagnosis, then learning to use humor—"Mom has cancer...your turn to do the dishes"—to normalize the illness with her teenage children.
The episode offers rare insight into how a physician navigates the healthcare system as a patient. Dr. Gould describes advocating for her own testing, seeking second opinions, researching treatment options, and finding the right oncologist who matched her communication style. Her experience defied expectations in surprising ways—the dreaded Rituxan treatments she feared would debilitate her "felt like water," while the seemingly counterintuitive "watch and wait" approach for a stage three cancer initially felt baffling.
Perhaps most valuable are Dr. Gould's reflections on how cancer transformed her practice. She now brings deeper empathy to patients awaiting test results, understanding their anxiety in ways textbooks could never teach. Though she initially planned to drastically reduce her workload, she discovered her identity remained deeply connected to her role as a physician—finding that meaningful work provided crucial psychological support during treatment.
Ready to gain perspective from someone who's experienced cancer from both sides of the stethoscope? Listen now and discover why having grace for others—and yourself—might be the most important lesson from facing mortality.
Hello, this is Jason Edwards and this is Doc Discussions. I'm here with Dr Julie Gould. Dr Gould did a previous podcast with us when we talked about hormone replacement therapy, but today we wanted to talk about something a little bit more personal. Julie, you were diagnosed with cancer relatively recently. Can you share your journey through your cancer diagnosis?
Speaker 2:Sure, and that's really why I'm here today just because there are so many people that were caught off guard by their diagnosis like I was. So traditionally through life, I had always been the person that you know, exercised and had their labs checked regularly and didn't microwave plastics and, you know, did all the things that you try to avoid when you don't want to have cancer. And my kids, like constantly would sit there and like laugh at me because I'm like, don't do that. You know that causes cancer. Don't eat that, no pepperoni, you're going to get colon cancer, like. So I was always that person that was very cautious of it. And then, you know, I live in a house where, you know, there's kids that eat their Cheez-Its and my husband does whatever he wants and doesn't really, you know, pay attention to a lot as far as, like you know, when it comes to like diet and they they're very nonchalant about it, and so I always kind of thought I'd be the person that lives forever though. So so when I got the diagnosis, I was, I was really kind of beside myself because I was like no, I'm, I'm, I'm the one that's going to live forever, though, like I'm the one that is going to be 90. And this was like such a shock for me. But the way that it started was actually I was on a ski trip and just taking a shower, shaving, and I felt a lump in my armpit. And this was actually like two weeks after I got the second COVID vaccine. And so, knowing none of us knew anything about COVID vaccines but we did know that it does make your lymph nodes get enlarged, though for a little while. So I kind of chalked it up to that for a little while and so I watched it for you know, a couple of weeks and I was like no, it's still there.
Speaker 2:And my husband's a physical therapist. I kind of was like this is kind of weird, do you feel this? And he's like yeah, I feel it. He's like do you have it on the other side? I'm like I don't know. I'm like I don't think I feel anything. And for a physical therapist like especially a manual therapist, they have really good hands. He's like no, you have it on the right side too. And I was on just the side that I got the shot in my arm.
Speaker 2:So I decided to sign myself up for a mammogram, because I'm like every physician and I don't see physicians. So I signed myself up, went and got it done, put on for an axillary ultrasound, and first they got done doing the mammogram and they said everything looks great. I'm like awesome, but I feel something in my armpits. And so the sonographer ultrasounded me and you can see the look on her face when she goes oh, oh, yeah, yeah, you do have some enlarged lymph nodes. And then they bring the radiologist in to take a look and then they're like yeah, your lymph nodes are enlarged, it's probably from the COVID vaccine. So they said you know, we have options. One is I could just come back in six months and repeat the ultrasound or I could have a biopsy.
Speaker 2:And so I, you know, thought about it and I was like I think I want the biopsy. So I said yes, and I immediately got in my car, went home and called Chris Hugie, who's a pediatric oncologist, and I said hey, you know, this is kind of a weird question. And he immediately was like get the biopsy. Like answer is always get the biopsy. And then he asked me something where he goes do you have any inguinal lymph nodes? And I, you know, like I kind of thought about it for a minute and I was like you know what I actually think I do, and I thought I was getting a hernia and I really wasn't appreciating like what was happening to me as being something that could be like a lymph node change, more so than like a musculoskeletal issue. So after he said that, I was like, yeah, I do have an enlarged lymph node like in my inguinal region and so you know. So that just kind of sealed the deal that I was getting the biopsy.
Speaker 1:Like emotionally, were you like gone at that point, or?
Speaker 2:Well, no, at that point I still was like we still are kind of holding on to that. I might just be having a reaction to the COVID vaccine, you know. And so, and because once again it was so new, I mean I was like the second person in line to get the vaccine, you know. So I was like, I was like I'm getting this vaccine, so, and we didn.
Speaker 1:I didn't know anything, and that was one of the first things that came out was like hey, like you don't need to ultrasound every right, left node, because this is a common thing, right?
Speaker 2:So I'm still kind of just holding on to like hope that that this is just a reaction. But you know, you know, after talking to my husband about it that night he was trying to make me feel better and say like it's probably not that. But I just kind of in the core kind of knew like I think it is something, I think this is something real. So I got the biopsy done and then, like within two days they called me and said they said yes, it's lymphoma. So I went ahead and called Chris Hugie again the first person I called. I didn't call my husband, I called him. I'm like it's follicular lymphoma. So he's like well, that's not like a traditional pediatric one. I can't tell you that much about it. But he gave me the name of the person at Wash U that's kind of known for treating lymphomas. But beyond that I had no idea what to do. So you were actually the next phone call after I told my family.
Speaker 1:I remember very well it was early in the morning.
Speaker 2:Yeah, so. So, of course, the initial night that I was told which, the night that I was told that I actually had cancer, I actually went to a surgery center meeting and I sat through the meeting actually Like I didn't go home, I just sat through it and was just kind of just in la-la land. And then I drove home and then told my family and drank a bottle of wine, and because at that point and then we do, we all do strange things when we're faced with mortality and we made my funeral playlist so at that point I was like, oh my God, I think I'm going to die. So like not knowing what to do, we were just like we started playing music and I had a glass of wine and we, you know, we just started, kind of like you almost you don't know, you don't know what you're going to do, until you're in the middle of it, Like how you're going to react.
Speaker 2:Is it going to be tearful? Is it going to be tearful? Is it going to be scary? Is it, you know, am I going to feel closer to God? Like you just don't know, like what's going to happen? At that point, and for me, like I just I think I was still mostly in denial, though, because you know I'm looking up information and still, just you know, I just couldn't believe that that was happening to me. So, yeah, the next day you were the person that I called because I had met you at social events and you're the closest person that I knew to oncology.
Speaker 1:I'm glad you called me.
Speaker 2:So, and then you got me in with somebody the next day, and that was. That was pretty amazing that it was that fast. And so, you know, I went in and met with the oncologist. He really didn't seem that excited by by me though, too.
Speaker 1:And so that made me feel which seems weird, kind of right.
Speaker 2:Yes, yeah. So I'm like, how is it that I can be not that exciting? But I have lymph nodes that are enlarged everywhere? And he seemed very, very much like. He was like you're going to be fine. I'm like, okay. So he set me up for my PET scans and then we waited for my staging. Then at that point, yeah, yeah, the I always.
Speaker 1:You know, I talked to somebody today who was like super healthy, like great shape, who ended up having like a serious cancer and it just like it's. Those people have the toughest time Now physically. They're in the best shape. You know to deal with it, right, because they've taken good care of themselves. But there's no justice to it, right? You know I always say you know your neighbors drinking bush light and eating Funyuns and like doing fine. And you're eating kale every day and end up with cancer. It's like this isn't supposed to happen.
Speaker 2:Right. And then you, the biggest thing is like you look for what did I do wrong, like why did this happen to me? Is it because I lived in California? You know I was exposed to things you know, like we used to have, like you know they would actually come in and do the crop dusting near where I lived, were you in the Central Valley. Yeah, the Bay Area.
Speaker 1:Okay, gotcha.
Speaker 2:But it was still like, I mean, they come and coat the. They would come and coat all of the olive trees and they would. Our cars would be covered with stuff, and that was just it. We'd be running around outside and playing, and and so I thought, well, maybe it's, maybe it's cause I'm from Northern California and this is where I grew up and and, ironically, my my old partner, teresa Knight she's the first person that I joined when I got out of residency. She had non-Hodgkin's lymphoma as well, and she's from Northern California though too, and she passed away at 49. So, like there's always that like looming in my life where I'm like, wow, we were very similar as far as like how we got to St Louis and then she was diagnosed and then she did pass away from it at 49.
Speaker 1:So and it's natural to try to with anything in life. Humans look for patterns, yes, and sometimes, you see, you know mirages, and sometimes it's reality, yeah, but in the midst of all that, you know, we're not extremely rational, right, and so it's hard to try to figure out what's up and down.
Speaker 2:Oh, yes, and that's why, like, you put your story out there a lot to see, like who connects with this, like who has a similar story though too. And I actually met somebody that has my exact story though too, which was very interesting though too, and, if you know, we've become friends and we've we've, we support each other and we've taken different directions for how we're treated and we compare like hers compared to mine, but it was like almost the exact same story though too. But you look for for people that you, you know, have similar things going on, that you, you know, that can help support you and you can support each other. But, uh, but you do do look for the similarities. Like what? What's the similarity between us? Well, she's from California, or, like, actually, I take it back, her brother, who also had non-Hodgkin's lymphoma, ironically enough, was from California and worked in farming also. So we're like, oh, maybe that's it. Like, maybe this is like something that has to do with, like, where we're from.
Speaker 2:Yeah, but then there's always the question of, like you know, was it the COVID vaccine? Was it you know?
Speaker 1:just every little thing that we do Like it could be radon gas from caves in the limestone of Missouri Right.
Speaker 2:Is it because I chose the career that I chose, you know, because that's the other thing. That's the other thing that you start to note is, more than anything, they'll tell you you have to take care of yourself, like, and you have to stop pushing yourself. You know, stop pushing yourself to such stressful situations. And, as an obstetrician, I'm up all night and I don't sleep.
Speaker 1:Yeah.
Speaker 2:But there's a huge like. There's an unusually a large amount of physicians that get cancer though too. And then you start to wonder, though too, is it because we put ourselves in this chronic state of inflammation? So there's like a little bit of guilt like that. I chose the career that I chose, is it? You know, is this like what made me potentially get this? Because I, I run at it. I run at 11, all day long, every day.
Speaker 1:I'll throw this in for the listener. So your immune system does a really good job at keeping cancer away, and so your body can develop cancer cells, but your immune system typically kills them before it becomes ever clinically evident. When you're an OB-GYN, you get up a lot in the middle of the night to deliver babies, and you have kind of this abnormal sleep schedule. Uh, your sleep is very tied into your immune system, and so if you have poor sleep, then your immune system's not going to be as strong, and so that's what Julie's talking about here is the connection between not sleeping, bad immune system, cancer, 100% it.
Speaker 2:So so you know. So when I went in to you know, have my second opinion, which is what everybody always says to you, go get a second opinion. That was. The one thing that she said to me was like you need to take care of yourself, like you need to sleep, and I'm like how do I do that? Though?
Speaker 2:I like my job, you know, yeah, you're like mid-career, right, you have kids and responsibility, and now you're trying to reshuffle everything, right, right, and I have, and I have tried to do that though too. I mean, sometimes I still kind of push myself back into the, the old ways, but I do try to protect sleep and try to make sure that my immune system is working as as well as it can, though too.
Speaker 2:Yeah, whether that caused it or not, the right thing to do is to optimize all these things, right but it just kind of goes back to the whole thing of like, you question everything like why, why me?
Speaker 1:and is really what it comes down to, yeah and and I think we're all trying to kind of live an optimal life and and it's, if anything's suboptimal, you know, I mean we make suboptimal decisions every day. You know it's like it. It's a good trait to take on personal responsibility for anything that's going on, but cancers, you know, unless you're smoking three packs of cigarettes a day, you know if it's a kind of a random cancer like this that was.
Speaker 1:You know you have no idea what caused it it was. Could have just been a random mutation, probably was that that caused it. So follicular lymphoma. So so when you went in, you know I'm sure you were expecting, you know you have this lymphoma, you're expecting to get kind of this treatment regimen and be on the chemo right away. But most of the time you just watch it.
Speaker 2:It is the weirdest thing in the world.
Speaker 1:And so it's hard to believe an expert when they're saying oh no, you'll just keep an eye on it, right, right.
Speaker 2:And when they said that it's watch, and Are you kidding me?
Speaker 1:That doesn't feel good, right.
Speaker 2:So, like I'm stage three, like they're like we're going to watch it. I'm like what do you mean? We're going to watch this, like this is insane, yeah. But then you really do read the literature and what everybody's doing and you're like, yeah, you watch and wait. Yeah, because the reality is, I felt fine, like I felt totally fine, though, too, and even though, like I could feel my lymph nodes and you know they didn't hurt, or anything like that. So we watched, you know, we watched it for like a year and a half before we kind of were pushed to say let's go ahead and start treatment.
Speaker 1:So why were you pushed to start treatment?
Speaker 2:Well, a couple of different things. So one is I got a fantastic dermatologist her name's Anna Clark at St Luke's, and she gave me a really thorough evaluation, and she's like your back looks like a war zone and biopsied multiple things on my back. So two of the three things she biopsied were cancer. One was a melanoma, one was a basal cell carcinoma, but the melanoma also had follicular lymphoma in it, though, too.
Speaker 1:Wild, so too Wild. So yeah, that's not normal right.
Speaker 2:Right, right so, but melanoma does run in my family, so it's not a surprise. You know, growing up in California, like we were You're light-skinned. Light-skinned. You know we used to put baby oil on and fry ourselves like because we just wanted to tan so bad and I am not somebody that tans, but you don't know that, like when you're a kid, and you just think that it's so cool. Yeah.
Speaker 1:So melanoma is also a very highly immunogenic cancer.
Speaker 2:Yeah, so renal cell.
Speaker 1:Melanoma and neuroblastoma are kind of classically known as being very sensitive to the immune system.
Speaker 2:So. So when we got that back, I was like and so I went to Dr Fessler, my, my oncologist, the best, he's the best, oh my God, I just love him. So he wasn't my original one, which I, you know, my original one was fantastic, but he left also. And then I got Dr Fessler, who's been fantastic and really lets me kind of lets me work at my pace, he doesn't push anything, and he kind of knows where I'm coming from and he, you know, that's why my, my girlfriend that has the same thing. We both had different treatment patterns. Because he let us do that, because he knew that was probably what we needed though too.
Speaker 2:But so then I went back to Dr Fessler and said you know, like, is this the strangest thing ever? I mean, I had my specimen sent off to Mayo. I'm like, are you sure? Are you sure this is like it? And so, sure enough, you know it was true, so sure enough you know it was true. I had, I had follicular lymphoma in my melanoma biopsy specimen. I got my melanoma treated, which was like, apparently we biopsied off the only melanoma I had.
Speaker 1:It wasn't even in, like my Was it inside you or was it beyond? Okay, good, yeah, yeah.
Speaker 2:So. So it was excised and all of that was taken care of. But then we decided we needed to do more imaging, and at that, and also along those lines, I could feel my lymph nodes getting bigger though too. So so that's like my hands are a very good barometer, I think, for like what's going on in my body, and so like I could feel my lymph nodes were getting bigger though too, but still felt fine once again. And then I got another PET scan, and it was in my bone marrow at that point. So at that point I hit the qualification, because of the size of my lymph nodes, that they say, well, we should probably initiate treatment though too.
Speaker 2:So you give me the options and I went with a single agent because I knew that it had worked well and I could always go back and do it again if I needed to also, was it Ritexan?
Speaker 1:Yeah, yeah, yeah.
Speaker 2:Yeah, but it's, you know, it's one of those things. You the other thing that happens when you get cancer is you get onto all of these Facebook groups, which I kind of should never have done that I agree.
Speaker 1:It selects because people who are doing well typically aren't spending much time on the message board Right, so it pre-selects for all the bad cases.
Speaker 2:Yes. But you hear, like all of these things were like, oh, I was on Rituxan and this happened and I had a patient that came in that said she went into cardiac arrest on it. I was like, oh my God. So at this point I'm like thinking that when I get Rituxan I am going to have to take all this time off of work. And it wasn't like that for me at all.
Speaker 1:Most people take it in stride.
Speaker 2:Yeah, I mean, like the first day I had it, I got steroids and I got Benadryl and that's the only thing that kind of knocked me on my butt was like like the Benadryl made me sleep.
Speaker 1:So, and psychologically too. I mean the day you know people kind of underestimate the mind and it's so powerful, but like the day before that first treatment, like you're not sleeping, well, you've got a million things going through your mind, got a million things going to your mind.
Speaker 1:If you have any side, effect at all it will be amplified by your mind, and I'm not saying like it's in your head, like your head is very powerful and and so people tend to be kind of and I would be too. If my toe hurt the next day, I'd be like, oh my God, it's from the cancer or the treatment you know they've noticed patterns that aren't real patterns, but but you did. You feel like you took the subsequent um Rituxan treatments in stride.
Speaker 2:Totally so, like after the first one, I was like it's not that bad and I'm like I was just sleepy, so they're like, well, we could cut back on on the uh Benadryl. And then we ended up cutting back on the steroids though, too, and I mean honestly, like Rituxan was like water for me, like I drive myself home from the treatments by the by. You know, when I got to the end of it, uh, I was like this doesn't, this doesn't bother me at all. So so then, after, you know, getting through all of my treatments, I had a repeat PET scan and it shrank, but it's still there. So, um, which is, you know, it's fine, uh, it's just one of those things that we'll just keep an eye on. And I've had a full body MRI since then also, and it's still just there, and it's not large enough that I need to have treatment again.
Speaker 2:But you know, next time around I'll probably do different treatment options though, too, but I just, you know, wanted to get through this first, and also, like my, my kids are young and I wanted to get through high school and, like you know, getting them into college before I start doing things that might really. You know that I'm you're always just scared, that is, that the treatment is going to knock you on your butt. So so, before starting the other new things, I'm like I think I could do Rituxan, but next time I'll probably, you know, add something. Add something onto that also.
Speaker 1:Yeah, this reminds me of a couple of things. I'm sure it was very frightening, especially having kids you know who were in probably like junior high and high school at the time, or maybe high school yeah, high school and junior high Okay. And so it's like well, how do you keep going? I mean, how do you keep being a mom, how do you keep having sympathy for your patients?
Speaker 1:Yes, oh not, yeah, and, and I think people can adapt to almost anything, and I'm not, you know, the original person who said that. I think it's like a Nietzschean quote, but it's like people do adapt and you know, usually even just a few weeks into a diagnosis. You've somewhat come to grips with it. Yeah, and how do you feel like you did with that?
Speaker 2:Well, I was so nervous about, like, how my kids are going to react to this, and that's what everybody is nervous about. Like how my kids are going to react to this, and that's what everybody is nervous about. Like, when you have young kids is like, how is this, how's this going to affect their life, though, too Like, are they going to be scared for me the whole time? And my kids are very different. I have a boy and a girl, and the boy, you know, obviously doesn't say anything, because boys keep all their emotions in, but my daughter was very much like. I mean, she, she and her girlfriends had, you know, an F cancer party for me, because they were, you know, juniors in high school.
Speaker 2:So they did all the things that they could do to, like you know, lift spirits, and so that was her way of like showing love and support. But I think that the best part of it was just being able to say the word cancer, though, too. So you know, so it did get to the point where, like, we could make jokes about it, and that's what I had to do, like just because I feel like the more I could say the word, the more they could say the word then too, and then they could talk about it then yeah so you know, like when it came to doing dishes, like you know, I, my kids never want to do dishes, but I'd be like kids, your turn to do dishes.
Speaker 2:Mom has cancer. You know, like, and they're like. They got to the point where they're like okay, mom, mom, it's getting old, you know. So like you, just to be able to say stuff like that to them and know that it's like joke, that I'm OK with it and that mentally I'm going to be fine with it, was a very big thing, though, too. And now they don't tolerate it at all though, too. They're like we don't care if you have cancer, come out and try to like run a half marathon with us or whatever.
Speaker 2:You know, like they really, it's like they're beyond it now.
Speaker 2:So, but, and then, as far as from the, from the, the, the, the physician standpoint of it, I do think it's made me more sympathetic, and it's made me understand when my patients are nervous about stuff, like waiting for things, and there are things that I would be like I don't think this is a big deal, your pap smear might be a little bit abnormal, but they're like sitting at home perseverating about it, and I understand that so much better now, though, too.
Speaker 2:And then also the fear that they have when they get diagnosis, like there's been several times I've called my patients after they have, like breast cancer diagnoses and kind of say look, this is how it's going to go, and being able to like kind of give them some guidance, for that has, I feel like, been very beneficial for me as a clinician being able to help other people.
Speaker 2:The person that helped me her name is Beth Gearhart. She was one of my partners and she you know she had gone through something similar, though, too and like, as soon as she found out I was diagnosed, she's like Okay, so here's what you're going to do. You're going to bring this pad of paper with you and write down all your questions before and make sure your husband goes with you. And then go get your second opinion and like she like scripted, like what, what are you supposed to do when you get cancer? And it was so helpful like having like a very motherly figure like that helping me with that, because nobody had ever really gone through anything like that in my family and they they didn't know what to do.
Speaker 1:I didn't know what to do, so that's If you were so so. So somebody's listening. Who just got diagnosed? Yes, what's what would, what would you tell them to do?
Speaker 2:Yes, take a breath, Like it'll, it'll be okay. And when you go to visit your doctor, like definitely bring somebody else with you and don't be afraid to get a second opinion. And if you're not jiving with your doctor, it's okay to get a different doctor. Though, too, like, if you have any reservations that, like the person you know that you're talking to is, you know, too busy for you or just doing protocol or you just don't feel that connection to, it's okay to get another doctor, 100%, it should not feel weird.
Speaker 1:It should not feel weird. It should not feel weird. If it does feel weird, you know it's definitely. I mean, st Louis is full of great doctors and great hospitals, right, and you can't throw a rock without hitting one, right? And so, like you have a lot of great options.
Speaker 2:Right right.
Speaker 1:And it should it's. You know it's not dating, but it's kind of like that, like it should kind of work together.
Speaker 2:Right, yes, because it's a long relationship. It is, it is so that's you know. That's the major advice is don't be afraid to get a second. Actually, I almost encourage you to get a second opinion, because otherwise you're always going to wonder if you're doing the right thing, though, too.
Speaker 1:There's one scenario where I tell patients it's probably a bad idea to get a second opinion, and that's when and it's not often, but it's when you have a cancer that's growing very quickly. Oh yeah, yes, and you need to move, and you need to do something today and I've had patients to say, well, I've got an appointment with Cleveland Clinic in three weeks, and I've told them you don't have three weeks. Yeah, right, yeah, and usually they almost always listen to that.
Speaker 1:And it's a rare scenario, but usually it's like very obvious that's the case Right and so, but otherwise no downside. The other thing I'll say too is with artificial intelligence I mean, a lot of these are great, and if you kind of put in like a very detailed description of what you have, you're probably going to get a very accurate output. And I would tell people not to Google or just do a search. But AI is different and it usually it hits the nail on the head.
Speaker 2:Yeah, but I feel like with with the kind of cancer that I have, it is all across the board for what everybody does now breast cancer, and you could tell me formulaic it is, and that's.
Speaker 2:You know, I had a patient that called the other day and she's like, well, I'm going to go get a second opinion. Um, at Missouri Baptist Cause, my, my sister, had a cancer and was treated by this person, and I'm like, really Like you're probably going to get the same answer everywhere you go for this. So so you just have to go with who you feel the most comfortable with. But the reality is is something as as common as breast cancer. Unfortunately, too many, too many people have breast cancer.
Speaker 1:There's enough protocol out there that most people go by protocol. There's clinical, a boatload of clinical trials, and so it's they've it's very clear what to do, and so you know per stage. And then, yeah, when you find something nuanced like this, you want some. Really, I Right. And then, yeah, when you find something nuanced like this, yeah, you want some. Really, I think you want somebody who's treated a lot of it.
Speaker 2:Right, you know volume, and that's exactly why I'm like happy seeing Mark Fessler, though, too, because he is our lymphoma guy Super smart, very nice.
Speaker 1:And also like. That's basically all he does is hematologic malignancies.
Speaker 2:Right, and then going back to the whole Facebook thing you get onto, you know one of these, you know Facebook lymphoma survivor group things and you hear their stories about them. I'm like who is treating you Like? There's so many times where I'm like this is so like, not like what I would consider normal, and they all talk about, like you know all these crazy treatments that they've had. I'm like, wow, like. If you think that that's normal, maybe it is for where you are, or maybe there's something they're leaving out.
Speaker 1:you know that happens to, you know. But there.
Speaker 2:I mean, there are a lot of questions that even like I don't understand sometimes, like you know, why? Why do some people have bone marrow biopsies for what I have and other people don't, you know, considering, like, what their stage is?
Speaker 1:Age probably plays a lot into the management, too, for your specific cancer, because you're young and I haven't seen that many young people with follicular lymphoma. Usually patients are in their 70s or 80s.
Speaker 2:Right, right yeah.
Speaker 1:Which you manage totally differently, because their life expectancy is kind of max 10 or 15 years, right when that's not the case with you. A lot of years we have to protect. So you've got to kind of be a little bit more thoughtful.
Speaker 2:Right, yeah, I mean I'm sure, like all these people on Facebook, I've had other reasons why they went to RCHOP, which is their type of chemo that they had, versus something different. But that's what I have seen is that it seemed like it was all across the board for what people's treatment was. So so for me, like just being able to the thing that I did is I looked up all these studies and I went in and I, you know, talked to Dr Fessler and actually, before I even spoke to him about what I think I wanted to do, he actually cited, like all of the papers before I even like said like oh well, okay, yeah.
Speaker 2:Okay, I'm like checking off my boxes as I go. So like everything that you know, I had come in there kind of going like with this study, said this he already like knew and it was like Bible to him, so so, so I felt very comfortable with that. But yeah, it was all across the board. So that's where I just kind of go. I don't know if AI would work for this particular one, but no but.
Speaker 1:But my guess is it would kind of give you a bunch of options and give some context to it. Yeah, and so how has this changed your perspective on life? And you talked a little bit about your priorities with work and stuff like that.
Speaker 2:Well, initially, like initially, like you go, well, I'm going to work less. Like that's everybody's answer, right, I'm going to work less. So you know. So I went to the powers that be here. I'm like cut my salary, I'm not going to work as much. That sounded really good in theory, and you know, I just don't. It's just not possible for an OB to like really just cut back, because it always ends up kind of like building back up again. But it would be horrible if I hated my job to begin with. But I really enjoy my job though too. So, even though I was like I'm going to travel more and I'm going to be more present, my job is such a part of my identity that like for me to say I'm going to step away from that, then I kind of go well, what else would I do?
Speaker 1:Yeah, I knew somebody with terminal cancer and they kept going all the way till the end and they were young and it's what they wanted to do.
Speaker 2:It also distracts me though, too. Yeah, yeah the alternative.
Speaker 1:I mean, this is one thing I very much tell patients to do Keep working if you can, and for three reasons. Physically, you're more active, you know, sitting on the couch, you know, or think, oh, I'm going to work out, or whatever. You don't. And then, psychologically sitting home on the couch and thinking about it is horrible.
Speaker 2:Right.
Speaker 1:You need useful distractions.
Speaker 2:Yes.
Speaker 1:And then you know, for most people financially like there is no stress, like financial stress, and if you can keep that check coming in, all three of those things make your life better. And so, even though plenty of people out there say I hate my job, like you know it's like Sisyphus pushing the boulder up the hill. Like you need the boulder, believe it or not. It doesn't feel like it, but you do, right, right.
Speaker 2:So so I, you know, I still work. I have, I have actually found a love for travel, so I do want to do that more, but I'm trying to figure out how to balance that with my job a little bit more, though, too. But I've always kind of vowed, like anything that has to do with my kids, like I always want to be there, though, too. So I still, you know, made it to all the hockey games. I still went on the college tours. I'll move my son in, you know, to college this summer though, too. So all of that stuff, I want to be there and it's very, very important for me and that's the most important thing, though, too. But you mend fences, though, too, like, so you, you, the people that you have had, you know, conflict with in your family like nothing makes you talk more than telling them that you have cancer.
Speaker 2:And suddenly, everything's okay.
Speaker 1:Everything seems pretty small right.
Speaker 2:It does seem very small, so so, so that part of it. Not that cancer's ever a great thing, but it does make you, you know, have this conversation with your family, and then you start talking again, somewhat, somewhat regularly, checking in with each other there too.
Speaker 2:So so. So that part of it like has been beneficial though too, and you just have. I feel like you just have more grace. You give everybody more grace though, too, because the things that are really important are like very clear to you now, and if somebody comes in all hot because you know you're running behind or they didn't want to pay a copay, like, I feel like I handle that kind of stuff so much better now, because I'm like you know what, in the scope of my day, this ain't that bad.
Speaker 1:Small potatoes right.
Speaker 2:Right.
Speaker 1:Yeah, that's really true. You know, talking about many events has made me think of a lot of you know. Especially when the AIDS epidemic hit, you had a lot of people you know from small towns or the Midwest who had gone to the coasts and then they got sick and they kind of came back to their small towns and had conversations with their parents and and and kind of um, maybe solidified these relationships that may not have ever been solidified and so like, through kind of the harshness of disease, you do see beautiful things, you know, if you keep your eyes open.
Speaker 2:Right, yeah, and that's, and that's kind of what I wrote about in that last. You know, I had that Facebook post about raising money for the leukemia and lymphoma society. Is that like it really, you, you, you do see the small things, like, I mean, when you go to the infusion center and you see these people that are just volunteering, just to volunteer, just to make you feel better, like it brings it. It really does bring like a tear to your eye, like when you're like, wow, like you're just doing this because you're just selfless and you want to help other people, and you see that so much more clearly, though, like when you're on this side of it, though, too. So, in like the day you came and sat with us, though, too, like it Like I'll probably tear up from this, though, too, it like meant more to me than you know, like anything.
Speaker 1:I was really, really sad, you know, when you called and told me that and you just want to do anything you can to help somebody out and to you know any little thing. And so it's, and especially you being so young, I mean it was really hard for me to like hear that, that had happened Right and yeah but you're right. I mean, there's beauty all around us. You just got to like right.
Speaker 2:You just got to look for it, yeah, but anyway All right On that note.
Speaker 1:Thanks so much. I appreciate your openness Anytime.
Speaker 2:I'm glad to share my story and I hope it helps other people too.
Speaker 1:Yeah, yeah, thanks so much, all right.