When Living With Serious Illness, What is Considered Courageous?

When living with serious illness, what is considered courageous?

"Don't let cancer define you," is one of the most common expressions among the cancer community. Throughout my journey living with brain cancer since the age of 12, I have felt pressured to prevent cancer from changing the direction of my life. I thought that persevering in spite of my diagnosis was a courageous act.

As the new decade begins, I've reflected more on the meaning of courage as I embark on an enormous transition in my life. For the past two and a half years, I have been living in California while studying in a joint medical and master's degree program at UC Berkeley and UC San Francisco. My goal coming into this program was to become a physician to work at the intersection of human and environmental health. However, my path took a turn when I was diagnosed with a second recurrence of brain cancer in March 2018, just nine months into my studies. Two months later, I had an awake brain surgery.

Since learning of my diagnosis that spring, I have contemplated whether to continue with my medical degree. I finished my first year as if everything was normal, but after surgery and receiving the news that the remaining parts of the tumor were more aggressive than previously thought, I decided to transition to school part-time. While I still wanted to move forward in my studies, I needed to focus on my recovery and maintain a decent quality of life. This meant putting my medical degree aside while I focused on my masters. Still, I had every intention though to return to my medical studies.

When my first treatment following surgery proved unsuccessful, I questioned my decision to remain in medical school, but ultimately felt I should keep pushing forward with my plans, or at least keep that door open. Countless times I would receive comments such as, "You're going to be such a great doctor" or, "It's so courageous you're continuing with medical school while being a patient." I internalized these opinions, which made me feel like I had a duty to stay in medical school. I had two identities, patient and medical student, that could help shape me into a thoughtful physician.

While I originally planned to write my Master's thesis on the mental health impacts of forest fires on California youth, my medical experiences and exploration of the illness narrative genre— drawing upon inspirations such as Julie Yip-Williams' The Unwinding of the Miracle, inspired me to pivot, turning my thesis into a book-length narrative about my journey with illness in medical school. Writing and reflecting on living with terminal illness strengthened my understanding of my values. I wanted, first and foremost, to prioritize my relationships with my family and my partner. Second, I wanted to use my experiences and privilege to help others.

As I neared completion of my Master's thesis, I came to a decision point of whether to continue with medical school. Over the past year, I had come to see that when living with life-limiting illness, it is not courageous to push forward blindly. Increasingly, I saw that I needed to recognize how my illness had helped to shape my values and, in turn, my path forward.

My values have guided me to put medical school aside and move back to the East Coast where my family and partner live. As a medical student, graduate student, and patient living in the Bay Area, I connected with colleagues, advocates, patients, and communities who taught me an important lesson: I do not need to be a physician to form deep, holistic connections with other people. I can do that through my own writing, advocacy, and experiences.

Every person living with a serious illness will respond uniquely to their diagnoses. The trope, "Don't let cancer define you," potentially prevents individuals from discovering new parts of themselves: aspects of their identity that could help them evolve to become someone they never thought was possible.

On New Year's Eve, when the clock struck midnight to start the new decade, I made a resolution to listen and respond to my values. While I have no idea where that will lead me, moving forward in this manner may be the most courageous act I can do for myself.