shattered

I haven't posted for a long time.

I survived intern year.  I survived residency, and through that crucible forged bonds that I'm going to have for the rest of my life.

I did a fellowship in urological oncology/robotic surgery as well - clinically one of the toughest years of my life but immensely satisfying.

I have a job in private practice, with a robust practice, great partners, doing cases I love, and a fantastic quality of life letting me spend time with what matters most - my two beautiful girls (currently ages 4.5 and 2.5). My wife is pregnant with a third on the way!

It was perfect.

I'm writing this post from a hospital room, much as my previous posts were written. But this is different.

I'm not a doctor right now. I'm not a patient. I'm a terrified father.

My youngest baby has been diagnosed with leukemia. Acute lymphoblastic leukemia.

The dark room I'm typing from is illuminated by the green glow of the IV pump that is currently transfusing her blood. Two days ago I watched my baby roll back into the operating room, the same walk I have made thousands of times, but always as the surgeon. I lost complete control over her while a team of doctors put in a port and gave her spinal chemotherapy.

The last week has been the worst week of my life. Nothing can prepare you for the pain of having a child diagnosed with cancer. I wish I had the ability to write down what  I was feeling, but I can't.

There is so much anger. Anger that all those years sacrificed in residency and fellowship to provide the best for my family - and in my first year of practice this happens.

So much fear. Childhood leukemia has a cure rate of >90%. But there is a ten percent chance my little angel doesn't make it. I can barely type out that sentence.

So much sadness. My daughter is two and a half - she needs two years of chemotherapy. I've been living this for 7 days and can't fathom how we are going to make it two more years. And my poor older daughter is already feeling neglected, but what can we do? And my unborn baby, due this upcoming March, will always be second fiddle.

Back to anger. I missed most of the childhood of my first two kids due to residency/fellowship. I wanted to be there for this third baby, experience all the small moments. I've lost that.

Now guilt. The above sentence is just selfish. My baby in the hospital needs me, and she's scared and suffering. She's so scared. How can I even think of myself?

And the worst is knowledge that things will never be normal again. For the next ten years (it takes that long to be fully declared cured) every blood test, every fall, every cold will invoke a sense of dread. The spectre of cancer returning will hang over me every day. And - if she is cured - chemo has its side effects. Decreased neurocognition, peripheral neuropathy, risks secondary malignancy, cardiac effects etc. How much does she understand? Does a toddler who spends week in the hospital, who is hobbled by chemo, who has her growth interrupted by steroids grow up to be well rounded? I don't care if she's not a physicist or lawyer or whatever - I just want her to be happy. I would do anything, give anything, trade anything, sacrifice anything for her to get through this unscathed.