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3 years on…

Claire Vicary is a GP, trainer and Training Programme Director in Doncaster. She was diagnosed with bowel cancer in November 2019 and has blogged throughout her recovery, charting the challenges faced as a doctor-patient: www.thisgphadbowelcancer.com

Today is my third “cancerversary”.

Three years since receiving my diagnosis rather unceremoniously via a screenshot of the CT scan with a “here you go” and a smile from the junior doctor.

And three years since I broke it to my husband that I had cancer.

I am still scarred by the experience. I am transported back there in a flash, frequently.

On the positive, (and it is quite the positive) it is three years without recurrence and for that I thank God. I have so much to be grateful for.

Three years of life.

Full on, family filled, crazy, hectic life!

Three years of memory making.

I wasn’t asking for any special treatment. I was simply asking for what any patient deserved.

The outlook is promising. I’m over the hump. The high-risk time for recurrence is behind me. Thank goodness.

But the truth is I’m not in a great place right now. In many respects I am finding things harder now than I did a year ago.

I am so tired. Utterly exhausted. For so many reasons.

When I completed surgery and my short-lived forays into chemotherapy, I never envisaged that a very different battle would only just be starting.

My diagnosis was delayed by a year. I have alluded to how challenging this has been for me to accept.

How could it happen?

I needed to know that I mattered. For people to have sufficient concern to review the case and see what could have been done differently. To review systems, identify failings and make changes.

I never anticipated that the process would be so incredibly difficult. That the “learning organisation” we are repeatedly told the NHS is, would be so unwilling to learn.

The quest for truth and explanation has been unbelievably challenging. Being a health professional trying to get answers has been harder than I have ever imagined. I can only imagine what the process must be like for a non-medic.

It has felt at every step of the process, the system has been deliberately obstructive. It is as if barriers are purposefully placed to break the will of the patient.

I wasn’t asking for any special treatment. I was simply asking for what any patient deserved.

To… know… I… mattered.

It seems I didn’t.

I’m feeling pretty broken. Battle weary. Exhausted from self-advocacy.

I’ve become embittered. Increasingly disillusioned.

And work is difficult.

Being a GP is all I have ever wanted to be, but I find it increasingly difficult to “represent” an organisation that I have so little faith in. A system that failed me, and continues to let me down.

I try my absolute hardest for my patients.

The focus in returning to work had always been about rebuilding trust. That I could hopefully foster enough trust in my “cog” or immediate sphere in the wider NHS machine, to be comfortable working.

I am so lucky to be working in a great practice. With a supportive team – clinicians who truly care. But I just don’t know if this is enough.

But if not this, what else?

This was always the dream, but I’m certainly not “living the dream” right now.

I am so lucky to be working in a great practice. With a supportive team – clinicians who truly care. But I just don’t know if this is enough.

I’m still angry, but the overwhelming emotion currently, right now is that of sadness. That this process has stolen something so precious to me. The joy I had in my job.

And I loved my job.

I am lost.

In the months post diagnosis, I was grieving. The loss of control was the hardest loss to bear. While my future was uncertain and I contemplated the possibility of recurrence daily, the prospect of returning to something other that general practice was never a consideration.

To find a job for life is a rarity these days, but medicine has remained one profession where for most, that really is the case. Now that is thrown into question for me, I am floundering.

General practice has always given me the rewarding, fulfilling, meaningful career I could hope for. I feel I make a difference. I do still feel that way. My ethical and moral values have always been in complete alignment with those of the “organisation” that I work for – the NHS – and in that respect I have never felt conflicted.

Until now.

My own patient experience has left me feeling that my values are so disparate from those of the wider organisation.

I have realised that since my return to work, I have been compensating. Trying to make up for the shortcomings I experienced. But doing so, day in day out, is exhausting. And I recognise it isn’t sustainable.

So I am left with a difficult decision. Something has to change. And it isn’t going to be the system.

That much is pretty clear.

In order to survive and achieve a working state that is sustainable in the long term, I am going to need to be the one that changes. I can’t keep doing what I am doing, the way that I am doing it. But that means compromising, and I just don’t know that I want to.

And I don’t know that I can.

I still feel guilty for not feeling more grateful. The guilt/gratitude complex is still at play and no less complicated, three years on.

But perhaps when it comes to these two “children” vying for this parent’s attention, I am possibly better at giving them both a voice. Allowing them both to exist side by side.

There is still a lot to process mentally. And there isn’t going to be any rapid conclusion to the ongoing battle. There are clearly difficult decisions in the months ahead. I have a lot of soul searching to do.

Today, though is a day to celebrate those three years. Three years of life lived.

And I am grateful.

Here’s to the next three…

 

Featured photo by Miguel Bruna on Unsplash

The BJGP is the world-leading primary care journal. At BJGP Life we add multi-media comment and opinion for the primary care community.

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