How I got my wake-up call

When her father became ill, this young physician had to make some tough decisions about her own life.

By Joanne E. Wilkinson, MD
Family Physician/Narragansett, RI

On the afternoon that changed my life, I was at my father and stepmother's house, waiting to meet friends for dinner. It was a rare day off for me, and I was thoroughly enjoying it—until my father told me a urologist had sent him for a CT scan to see if he had kidney stones. "I didn't," Dad said, "but he saw something in my pancreas and wants me to go back for more tests. Do you think I should bother?"

My heart dropped to my toes. You don't have to be a subspecialist to know that "something in the pancreas" isn't good. I kept it together on the outside, but inside I began to panic.

My father, 58 at the time, had always been healthy, but his mother had died of pancreatic cancer while I was in medical school. I have no brothers or sisters, and my mother died when I was 9. For a long time, my father was my entire family, and I'd often worried that something would happen to him.

As it was, I already faced plenty of stress. I'd accepted a demanding job with a well-respected group a few blocks from the hospital. I felt lucky to get it because I really wanted a job that would allow me to use all my skills and teach residents. I also admired the other physicians in the practice.

I learned a lot, became came even more efficient, and logged plenty of OB and inpatient hours. I loved working with more experienced physicians. Still, I was unhappy with my lifestyle, and it showed. My GERD got a lot worse than it had been during my residency. I developed iron-deficiency anemia from my diet of convenience-store food, which was all I seemed to have time for since I was logging such long hours. And my hour-long commute to work was getting to me. Extra worry about Dad was the last thing I needed.

I wanted to be at my father's side

My father's second CT also showed a small mass, and he was scheduled for needle biopsy. I wasn't optimistic. He would need a Whipple, and I'd seen only bad outcomes following those; in fact, all the patients I knew of who'd had Whipples had died within six weeks. A Whipple was, to me, the equivalent of calling hospice.

Although I admired my father's surgeon, in my heart I still believed Dad would have a Whipple, become a cancer patient, and probably die within the year.

The week before his surgery, I thought about how I'd always envisioned my role if he were ill. Sure, I'd provide medical advice, but most important, I would be there, available to spend time with him—not stuck in the office after hours. One day, while speaking with one of the residents after Grand Rounds, I found myself in tears. The resident, whom I'd supervised and helped during her own difficult internship, looked me in the eye. "You know what you have to do," she said, "don't you?"

And so I left my job, after just 18 months. I felt sad, guilty, and, on some level, like a quitter, but it was the only decision I could make in good conscience. I wanted to know I'd done everything I could to be with my father before he died. Since I had essentially no money saved, I planned to moonlight. But my financial worries paled next to my concern about Dad.

The Whipple went well, and Dad was home eating ice cream 12 days later. His path report did show adenocarcinoma. His surgeons were incredibly kind to me, and during the 10-hour operation several friends, including two residents I'd supervised, sat with my stepmother and me in the waiting room. That was one of the most helpful things anyone has ever done for me.

The day my father was supposed to start his chemo, he got a call from the oncologist. After reviewing his slides, the pathologists felt Dad might not have adenocarcinoma after all, but a much less aggressive mucinous cystic tumor. And because it was so small and encapsulated, further treatment would likely be unnecessary. A subspecialty pathologist at a major cancer center ultimately confirmed this, so Dad avoided chemo. His quality of life is excellent, and he's enjoying retirement.

Dad's illness was a wake-up call for me

More than two years have passed since Dad's surgery, and these days the balance of my life and work is completely different. For a year, I did a variety of urgent care and locum tenens jobs near home, working two to five days a week and averaging the same take-home salary I'd made at the practice. I advised residents and taught at the medical school, and I loved it.

I devoted more time to writing, attended hockey and baseball games, and spent more time than ever with family and friends. I took vacations, sold my condo, finally saved some money, and joined a masters swim team and a softball team. I felt happier and healthier than I had in years and began to enjoy my job again.

I was so transformed by having control over my schedule that I decided to begin a part-time practice with a friend, sharing office space about 10 minutes from my home. It's busy at times and involves more financial risk than working for someone else, but being my own boss is worth the sacrifices.

If my happiness were the only thing at stake, I think I'd have continued indefinitely in my old job, rather than think of myself as a quitter. But my father's illness was a wake-up call that made my priorities very clear. It gave me a second chance to align my life and my work, and now I'm determined not to compromise anymore.

My father's oncologist once said to him, "You have been given a gift." In a way, I think Dad and I both got a second chance at life, and neither of us intends to waste it.

 

Joanne Wilkinson. How I got my wake-up call. Medical Economics Apr. 25, 2003;80:80.