T Behind Enemy Lines: A Personal Perspective PersONAl reFlectiONs FEA

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Canadian OnCOlOgy nursing JOurnal • VOlume 26, issue 4, Fall 2016
reVue Canadienne de sOins inFirmiers en OnCOlOgie
FEATURES/RUbRiqUES
PersONAl reFlectiONs
Behind Enemy Lines: A Personal Perspective
by Tracey Moatt
The doctor nods to me, as he excuses
himself from the pastel-coloured
examining room and pulls the door
tight behind him with a piercing dou-
ble-click of the latch. It is a mystical
door that changes lives in an instant;
a door you step through as an individ-
ual seeking consultation, and one you
exit as a person living with cancer. I sit
in silence and wait, as Jane, a single
middle-aged woman, struggles with an
accumulation of unspoken thoughts
and emotions. I hesitate slightly, and
roll my stool closer to her in an eort
to ll an emptiness. I am acutely aware
of Jane’s trepidation, as my ngers d-
get with the ballpoint pen secured to my
lanyard. I know she needs to hear she
is not alone. Jane looks to me with fear
welling in her eyes, and desperation ll-
ing her voice, “What would you do?” she
whispers.
When I rst began working in the
melanoma department, as a research
nurse in clinical trials, I joked with my
colleagues that I was the poster child
for melanoma: red hair, blue eyes, fair
skin, multiple moles, and vulnerability
to sunburn easily. As a young healthy
woman, the thought of having skin can-
cer had never crossed my mind; that
is until the freezing from my biopsy
started to wear o. For as long as I could
remember, I had a dark mole in the cen-
tre of my chest, just under my bra line.
After being introduced to the mela-
noma department and learning I was at
an increased risk for melanoma myself,
I decided to have it biopsied. “I would
rather have a biopsy scar,” I said, “than
have melanoma.”
Unfortunately, I ended up with both.
“I’m so sorry, it’s melanoma” stopped
me in my tracks. My thoughts scram-
bled, “How can I tell my dad I have mel-
anoma? Mom died nine years ago today
from breast cancer!” as I spiraled into a
sobbing mess.
My melanoma experience was a
whirlwind that left me with little time
to process my thoughts. Less than a
week later I was on a friend’s couch with
a fresh railroad of stitches stretching
across my chest; the anesthesia gently
wore o as I struggled to pretend I was
dressed for Halloween.
The days after surgery felt like an
eternity, as I awaited my pathology
results. The news nally arrived only
a few days later: the cancer was caught
early. I was lucky. Even so, the diag-
nosis left me trapped inside my head,
having diculties focusing on any-
thing else. I saw myself mirroring my
mother’s fate. Diagnosed with can-
cer at a young age, dying a few years
later; I believed her destiny would soon
become my own.
I promptly became fearful that can-
cer was not nished with me and had
further moles removed. To this day, I
continue to nd it dicult to appreci-
ate how a piece of me could have been
cancerous. It had been a part of me for
as long as I could remember, yet this
mole penetrated my defense system. It
betrayed my body like a spy inltrating
enemy lines. It was especially devious
because my dermatologist’s well-trained
eye had not been the least bit persuaded
the mole was suspicious.
Going back to work was horrible. I
would see my patients’ biopsy reports
and ruminate over comparisons
with my own. Around every corner I
would glimpse reminders of my own
mortality.
Four years later I remain can-
cer-free and have come to terms with
my diagnosis. Returning to melanoma
clinical trials, with a new perspective
and rst-hand experience allows me
to advocate for my patients’ best inter-
ests. It oers me a powerful motiva-
tion to ensure they receive the care
they deserve, as I know what care I
might want in the future. I nd inspi-
ration in knowing the tables can be so
easily turned.
“Jane, I understand that you are
scared and would do almost anything to
ght this cancer, you need to ask your-
self what is right for you.” I explained
that, “Melanoma is a very deadly skin
cancer, which, until recently, did not
have many treatments and results were
almost always poor. But now there are
options, with improved outcomes,” I
reassure her.
“Jane, I’m sorry I don’t have the
answers you are looking for,” I say, as I
place my hand softly on hers, “I wish I
did.” I counsel Jane to decide what risks
she is willing to take and strongly rec-
ommend she consider her own personal
situation.
My key message is simple and I
press it further, “Jane, even though I’m
sitting here with you, please don’t feel
obligated to accept treatment because
we’ve presented a few options. It’s
important for you to choose because it’s
the right thing for YOU to do.” Our soci-
ety focuses on ghting and conquering
cancer, but it is rare for patients to hear
that it is okay to step back to focus on
their priorities.
I may never reveal the true intimacy
when asked, “What would you do?” but
I will support Jane’s decision-making
process; ensuring she has the informa-
tion to make a well-informed medical
decision.
ABOut tHe AutHOr
Tracey Moatt, RN, BScN,
MHSc(C), CCRP, Princess Margaret
Cancer Centre, University Health
Network, 610 University Avenue,
Toronto, ON, M5G 2M9
416-946-2000
Tracey.Mo[email protected]