This post is from 6/7/12. I don’t know if it is the best written of my posts and it certainly isn’t the funniest but it describes a painful part of this experience for me as person who is more accustomed to a caretaker role. I had to adjust to accept help and support and also to knowing that I was asking more of my support system than I could paid back. I hate that! The harder part, however, was telling the parents of the patients in my practice. I also ended up having to tell some of my patients, who are children and teens, when I had to take off 4 weeks after my mastectomy.

I know that my illness has impacted the families I see in that they are less able to depend on me always being there for them. I’ve since had to do professional consultation to assess whether my illness is significantly threatening my competence. This kind of consultation is required by professional ethics and following the ethics code is the law. Since I had already shifted my practice to primarily doing evaluations instead of psychotherapy (I needed to get home earlier and psychotherapy needs to take place during the after school hours, otherwise it is too disruptive for kids), most of my patients were at most inconvenienced by some rescheduling and my needing an extra day to return phone calls or emails. But there were a couple of kids who I thought were going to need me to be more available than I can be in the spring with my TRAM surgery, so I have transferred their care to other providers. Fortunately, the fact that I don’t look sick and actually look healthier than before my diagnosis has been really reassuring to folks.

I have a bit of a headache this morning. Yes, I had the wonderful news yesterday about my genetic test results. I really was quite elated. I’m still very happy about it deep down, but at the moment I am feeling a bit numb. I told a lot of parents about my cancer and a couple of teens. One of them is a girl I just started seeing again for counseling after a couple of year gap. Her mom just finished a really aggressive experimental treatment protocol for cancer (not breast). Ugh. This is not the kind of thing I wanted to have to tell her. The conversation went relatively well and we will see how it goes.

Yesterday, one of the parents I told got pretty teary eyed and another gave me a hug. I also received an email from a physician I know who works at Swedish who found out through the grapevine, had questions, offered help, and upon finding out who my physicians were, told me that he knew them and that I was in “excellent hands.”

Then there’s the constant support of friends and family who have been there for me through this as well as other ups and downs in my life. This last 12 months has been really the most challenging time in my life. (The non-cancer reasons will have to wait for coverage in a separate blog, but I’ll give you a hint. Parenting + teen girl.) Because of this, I do have a concern that comes up from time to time that I am really getting more from family and friends than I am giving back. But it is a manageable concern and I know that it is part of life and how we support one another. It’s not always equal.

So with all of this wonderful life affirming kindness, why the headache this morning? Well it’s not like I don’t see kindness every day because I really do. I think it’s in part because it underscores the gravity of my situation. Another part has to do with being a person who is more comfortable as a caretaker. Although I do like to be taken care of at times, I don’t like it to be my primary role. Finally, as a psychologist, we are trained to be caretakers and there are actual ethnics and laws around keeping our relationships with clients and their families professional. Legally, we are to required to avoid “multiple relationships”. In other words, the only relationship I am to have is to be their psychologist. I can’t be a friend (though I certainly know families with whom I would love to be friends with under different circumstances), I can’t do other business with clients (though I admit I bought Cub Scout popcorn from one of my former clients–he was right in front of the grocery store with a big smile on his face, it was for charity, he’s not roofing my house, I think I’ll be able to keep my license), etc. But because I help kids and their parents with issues close to the heart, the relationships I have, though professional, can also be very close. It’s a unique relationship, it can be an intimate relationship, but one without total reciprocity. The closest analogy is being a parent. As a parent, we have the responsibility to do the lion’s share of giving.

So, although I don’t want you to read this and think that I am fearing that by sharing my cancer status with families that I am being unethical, it is an awkward and uncomfortable experience. And there are a couple of kids who I think may have a particularly hard time with this. One of them I only see every 4-6 weeks, so she may be able to stay out of the loop. But the other kid I see on a weekly basis. I had my monthly consultation group with my psychologist friends/colleagues and I decided to hold off telling him unless I have to and certainly not until I have more information about my treatment plan.

My head is starting to feel a bit better. Thank you, Blog.