Like most of the rest of us, I began 2020 with all the hope and optimism that comes with celebrating the start of a new year.
In the summer of 2019, I finished my residency in emergency medicine and started working as an emergency medicine attending physician at a large community hospital. After over a decade of training, I was more than ready to finally enter the working world.
I was enjoying my role and, after years of living away from home, had signed a contract to start working at a hospital in my home state so I could be near my family and many old friends. At 30, I was looking forward to my life and my future more than ever.
When springtime came around, the COVID-19 pandemic had escalated in the United States to a concerning degree. My colleagues and I were bracing ourselves for the wave of sick patients we knew would be coming through our doors.
I had never been one to shy away from a challenge, so as I prepared myself to work on the front lines of the pandemic, I felt more confident than ever that the emergency room was the right place for me to be.
In fact, I was the ideal person to be caring for COVID patients. I was young, healthy, and had no children or other relatives living with me with a high risk of the disease.
I wasn’t scared of COVID, not for myself. But I knew I had to be there for my patients who weren’t as lucky as I was.
Then one day in April, I came down with a fever of 103°F, and my first reaction was paralyzing fear that I had spread the illness to one of my patients or coworkers. I had no other symptoms, but I had taken care of several COVID-positive patients over the last couple of weeks and was fairly certain that I had COVID.
I notified my supervisor, who arranged to cover for my absence, and I set in to quarantine. By the time I was able to get to the clinic for a COVID test, I had spiked a fever every day for nearly a week. This was quite unusual for me — I hadn’t taken a sick day in 10 years. I never got sick.
The provider laughed a bit and reassured me that I didn’t. It was a ridiculous notion, as I knew quite well. What else could I have other than COVID? But he agreed to do the bloodwork anyway.
I knew when my test results came back that something was wrong. My COVID test had been negative. And my blood count showed all sorts of abnormalities — I was anemic, my platelets were low, my white blood cells were low. All of this could happen with a virus, of course. And COVID tests were known to have false negatives. All I could do was wait to feel better.
Two weeks went by. Every day, like clockwork, I spiked a fever at about 5 p.m. Sometimes higher, sometimes lower, but it was always there. A second COVID test was negative. A chest X-ray was negative. A mono test was negative.
Three weeks went by. What did I have? I was referred to an infectious disease doctor, who tested me for malaria, because I had traveled internationally fairly recently, as well as for several tick-borne illnesses, and everything else we could think of. Still, there were no answers. And still, there were fevers.
As a physician, I knew what the differential diagnosis was for a fever of unknown origin. Every day that went by without a diagnosis I knew meant that the likelihood of malignancy was higher. Still, it was hard to accept. Since when does a healthy 30-year-old get cancer?
Well, apparently that healthy 30-year-old was me. After 6 weeks of this mysterious fever, a CT scan revealed that I had lymphoma. This was soon confirmed by two biopsies and a PET scan. It was already at stage 4.
On top of that, I actually had two types of lymphoma — a rare variant of Hodgkin that had transformed into an aggressive form of non-Hodgkin.
I was no longer allowed to work in the ER — the risk of infection was far too great. I went from being an exercise junkie, running more than 20 miles a week, to barely being able to get out of bed.
Since my diagnosis, I have gone through five rounds of inpatient chemotherapy, with three hospitalizations for fevers requiring IV antibiotics.
Everyone handles cancer differently, and every cancer patient has different struggles. For my part, one of the most difficult aspects was the sudden loss of purpose. For years, I had trained to become a physician. I didn’t even get a full year of actually practicing before this career was suddenly snatched away from me.
This was supposed to be a time when I was the one helping others through the pandemic. I was supposed to be fighting against the ravages of COVID. Although my body felt sick, my mind was still frustrated by this lack of purpose. I was not used to sitting on the sidelines.
I put out some feelers for nonclinical work options that I could safely and physically perform while undergoing chemo. I was lucky to hear of an opportunity, through a friend and residency colleague of mine, to work as a clinical lead for an innovative company called Clearstep.
Clearstep is a rapidly growing digital health startup that provides some of the largest healthcare companies in the country with a solution for virtual patient triage, resulting in an integrated platform for symptom checking and care routing.
This quickly proved to be an excellent way to use my skills as an ER physician, since triage is what we do every day.
Our medical system has long struggled to effectively connect patients with appropriate care options — something I witnessed frequently when working in the ER.
So many patients get tangled in the complicated web of different practices, clinics, and referrals, unsure where to go to seek care. I now work to help develop and refine the triage protocols as part of this effort to ensure that every patient can navigate the system.
Not only has working for Clearstep been a wonderful way to safely keep up my clinical skills while my cancer diagnosis leaves me unable to work in the ER, but it has been a great opportunity for me to advance in my field in a meaningful way. I use both my expertise as a physician and experience as a patient to help create a patient-centered approach to care.
I am finished with my treatments and just received news from my last PET scan that I am now in full remission. Although I cannot pretend that I would initially have chosen to go down this path, I can be thankful for several things.
First, I am certain that my experience as a cancer patient will help me become a better physician. The fear, uncertainty, and lack of control over your own body are feelings that nearly all patients experience, and I will hold this with me as I eventually return to clinical practice.
Second, I am truly grateful for the opportunity to remain a part of the medical field while unable to practice, and I am looking forward to continuing my role, even as I go back to clinical practice.
I was in a very different place at the end of 2020 than I was at the beginning. I could never have anticipated how the events of the year would unfold, not only for myself but for our entire population.
We have all struggled this year. But from darkness, we must find light. I am grateful for the light that I found in the darkness. And I look forward to this new year with all the hope and optimism of every other one.