Monday, June 1, 2015

As Luck Would Have It

Traveling through the internet as I do on a more-than-necessary basis, I came upon a little gem of an article from the Gainesville Sun about a veterinary oncology surgeon who also happened to be a cancer survivor and author. In her book which was just published last year, Dr. Sarah Boston, Associate Professor of Surgical Oncology at the College of Veterinary Medicine at the University of Florida, lays out reality as she knows it:
  • about how, while living and working in Canada, she encountered a sluggish and apathetic medical system when trying to get her thyroid carcinoma diagnosed and treated; 
  • how the human medical field seems to pale in comparison to the compassion that is a hallmark of the veterinary field; 
  • and how her writing became an outlet for humor and a place of solace. 
Lucky Dog: How Being a Veterinarian Saved My Life captures this meaty goodness and tenderizes it into an interesting piece on the table of veterinary authors.  

Let's get to know Sarah a little better.

"This all started just over four years ago," Sarah says. "I was living in Canada at the time. I was getting ready for bed and putting lotion on my neck and I found a mass. I knew it wasn't there before because I'm a veterinarian and an oncologist and I touch things for a living. I just knew it was my thyroid. I don't want to say I panicked, but I just thought it would be like veterinary medicine and I would go to my doctor and he would get me to a specialist and I would have surgery in a week or two."

Quickly enough, Sarah found out this was not the way things were going to go at all.

"Things just ground to a halt," she continues. "Four doctors told me it probably wasn't cancer and that it had been there for a while and it was probably benign. Everything was so slow. I couldn't even get an ultrasound for a week and a half."

In the meantime, Sarah borrowed her husband's (a large animal veterinarian) ultrasound. The image she saw confirmed her fears. "It looked like a thyroid carcinoma in a dog and I've done that surgery hundreds of times. I follow my patients up with ultrasound, so I know what it looks like in dogs. I looked at my ultrasound and was like: OK, no."

Winding her way back and forth to specialists, Sarah entered a scary time. The mass was growing and she felt no one was listening to her. Finally, two and a half months passed between when Sarah found the mass and when she had surgery. "I couldn't help but compare what I would have done for my patients," she says. "They would have been in and out within a couple of days. I couldn't even get an ultrasound in that time when I had the same health problem."

During this process, Sarah began to do what a lot of people would do -- seek an outlet. Hers was writing. "I was just frustrated," she says. "I was writing these little essays. It was really about trying to make my situation funny--me trying to amuse myself. That was really the initial reason for me starting to write. It was cathartic."

Sometimes, writing begets writing (aren't we writers lucky enough to sometimes reach that point?) and Sarah soon found herself with 40,000ish words--way too much for a blog, way more than just a couple humorous essays.

--Writers, this is where Sarah's story gets surreal. Stick with me, here. Think the ultimate writerly dream of meeting someone on a chance encounter and ending with a book deal is the stuff of fantasies? Hold on to your hats.--

Sarah attended a gala at the Animal Cancer Center at the University of Guelph. Speaking at this fundraiser, Sarah decided to read a few of her essays, "So I could explain to the donors why animal cancer is important and how it relates to human cancer," she says. As the Fates would have it, Sarah was sitting next to Noah Richler, a well-known Canadian author. After her reading, "Noah pulled out a pad, got my information, and said he was going to put me in touch with the best publisher in the country," Sarah says. "And I was like: OK."

At this point, Sarah had had two thyroid surgeries and was undergoing radiation. Although she originally didn't expect anything to come of this serendipitous meeting, she soon received an email from Noah introducing Sarah to his wife, well-known in the publishing world. "Through that connection, I sent in a partial first draft. And then I had what I call my Sex in the City moment: I basically walked in and had a book deal within 15 minutes. I was completely stunned, not expecting that at all."

OK, OK. Calm down. See? These sorts of things CAN happen. The Writer's Fates are REAL.

Anyway, back to our subject. Fast forward to the finished product, a book that shares both Sarah's thyroid experience and the experiences of her own four-legged cancer patients. More than a memoir, Lucky Dog carries with it a few strong messages.

"The book has a really strong message of advocacy," Sarah says. "You need to be a really strong advocate for yourself, your dog, your family member who is having health issues. No one cares as much as you do about your health. The thing that scared me the most about my whole process was that multiple times I was told, sort of, to go home. We'll watch it. And I remember thinking that if I were a history professor or someone without this medical background, then, who knows."

A cancer scare or any death scare, really, can make one realize or appreciate on a grand scale how delicate, how short, how precious life really is. (Says Seneca: "Life is long if you know how to use it.") Sarah touches on her realization of this, too. "Thinking I have cancer, then having cancer, then being treated for cancer creates this feeling of living in the moment," she says. "I learn that from the patients I see. Just because my patients have cancer, they don't sit there and worry about it and think about how they're going to die. They are enjoying the moment and quality of life. I think anyone who has had cancer or a cancer scare, they come to the other side of that. They get to where dogs are. Even though you may have a relatively long life, it's not really that much time so make sure you're happy. Someone told me after reading the book that I feared being unhappy more than I feared death. And I think that's true. Be happy in your life."

"Get to where dogs are."

This wouldn't be a talk about a veterinary memoir if it didn't include a reference to the venerable James Herriot. Sarah addresses this outright: "I was trying not to be another James Herriot. I love him, but I was trying to be another voice in veterinary literature, trying to shed some light on what we do as veterinarians, to help people understand what goes on in our profession. I'm actually considering writing another book on that subject because I think it's an important area to explore."

Given how Sarah found herself at a unique juxtaposition between the same human and veterinary professional specialties of oncology, naturally her book includes discussion on the differences and similarities between the two. "I think there are many ways in which veterinary medicine works better," she says. "I think we are more efficient, more compassionate. We spend more time with our clients, sometimes to our own detriment because people get burnt out and suffer from compassion fatigue. But it's what we do. To compare the time my surgeon spent with me to what my clients ask of me, it's not even in the same world. I'm trying to show that."

And of course, any dialogue on health care must invoke opinions on socialized versus privatized care, especially now that Sarah lives and works in Florida. "There's a little bit of the book contrasting Canadian and US health systems," she says. "I actually don't think socialized medical care is bad. I'm Canadian and believe strongly in socialized medicine. In the end I was treated and it didn't cost me any money but the problem in Canada is it's slow. There are inefficiencies. But, everyone is covered and has the right to have the surgery they need without financial hardship."

Of course you're all wondering, as I was, how Sarah is doing now. I was relived to have her tell me she's great. Her treatment lasted a total of nine months and she laughs this off by saying it was good for writing. "Thyroid is a "good" cancer," she says, "because it has a high cure rate. I'm inching up on that magic five year mark." With no cancer in the lymph nodes, clean margins, radioactive iodine and total thyroidectomy--the whole kit and kaboodle--Sarah says her check ups have been good.

We ended our conversation on a light note. Sarah wanted to emphasize how her book was meant to be humorous and says the most common feedback she's received from the book is that people say they laughed out loud and cried. "To me, that's amazing," she says. "I think as you're going through something like cancer, you have to find a way to have humor in it because it's about finding joy. Try to find the laughter and the joy in things."

I can't think of a better way to end a blog than that. You can follow Sarah on Twitter: @DrSarahBoston.

See you in two weeks--next post will be Monday, June 15.

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