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On Human Nature

This past Friday, in front of my family, friends, colleagues, and teachers, I accepted my diploma during the graduation ceremony for the UCLA psychiatry residency program.

While it wasn’t my real diploma — it’s been months since I’ve been able to work, so when I’m better I need to go back and finish some requirements — my residency program coordinator put together an awesome fake diploma so I would have something to pick up when my name was called. It looks just like the real thing but reads, in small letters, ”Elana Halks Miller has almost completed training in the UCLA Psychiatry Residency Program.”

When I start my private practice it’s getting framed and going straight up onto my wall. I  wonder if some astute patient will notice the “almost” tucked away between “has” and “completed,” and think to themselves, Hey… wait a second.

The evening — marking the end of a total of twelve years of training — encouraged me to reflect on the experience of having cancer from the perspective of being a psychiatrist. Something about severe illness striking down a young, otherwise healthy woman seems to have turned me into a walking Rorschach test onto which people have projected, for better or worse, their ideas about how the world should be. I may have learned more about human nature in the last six months than I have in all my adult years prior.

(P.s. — If my program director is reading this, maybe we can talk about me getting some clinic credit for having cancer? Eh?)

Some people see me and seem obviously discomforted, as if I force them to confront a reality about life they don’t want to confront. Perhaps there isn’t a greater force in the universe ensuring that bad things only happen to people who deserve them. Perhaps life isn’t fair. Perhaps if I am fragile, and mortal, then they are too.

Many people will say things, that, on some superficial level, they must believe are for my benefit, but that clearly deep down are meant to reassure themselves. They insist to me, “Everything’s going to be okay” (Oh really? Have you been talking to my oncologist? I’d love to hear the update), or say cliches like, “Everything happens for a reason” or, even worse, “God only gives us what we can carry,” (as if some greater force purposefully gave me cancer).

I have experienced a whole spectrum of generosity — from, on one end, generosity that is actually selfish, where people offer me support because they like how it sounds rolling off their tongue, but disappear when I actually need their help.

Others offer a transactional type of generosity: they give support, emails, cards, and gifts, but in return expect me to reflect back to them what good people they are (“Where is my thank you card?” they ask, or “Why have you not responded to my emails wishing you well?).

They think they’re being generous, but I come out of these experiences feeling uneasy and used, now obligated to return a favor I didn’t ask for and entered into an implicit contract I didn’t agree to (I wish I’d just be spared these “gifts” and the work that comes with them).

Their generosity is offered with the expectation that I do something in return, which, when you are sick and can barely peel yourself off the couch to get to chemo, is not generosity at all. I want to tell these people I’d love to spent all the time in the world reassuring them of their goodness, but I’m kind of busy with other things, like, you know, dealing with cancer.

(By the way, if you really want to send a helpful message to someone dealing with illness, say, ”I’m thinking of you. Let me know when you need anything. No need to respond.” Those last few words will be music to the person’s ears, I assure you, and will set you apart from the surprisingly high number of people who have a subtle expectation of having their ego stroked when they offer help).

The truest kind of generosity — which is offered with no concern for the ego of the person doing the offering, and total love for the person to whom they are offering something — is touching, and beautiful, and rare. I don’t know if I would have believed it existed if my closest friends and family, and even many strangers through this blog, hadn’t so clearly demonstrated it.

Some handle their discomfort with my illness in other ways. I’ve been cornered so people can force upon me vague  ”life advice,” telling me what attitude I should and shouldn’t have to deal with cancer, perhaps because they want to feel they’re smart and clever and have some important insight I need to hear.

I’ve had near-strangers divulge their personal problems to me at inopportune times. A few weeks ago a former coworker I hadn’t spoken to in years found me sitting by myself at lunch while I was waiting for a doctor’s appointment, sat down, and promptly unloaded onto me about her work, family, and interpersonal problems for the next twenty minutes.

I had just ordered a delicious sushi lunch, yet was now pressured to confront my own Sophie’s choice — eat two more pieces of sushi and be forced to hear more about the school administrator who didn’t properly appreciate her son’s contribution the classroom, four more pieces of sushi and give her a chance to start the story about her husband flirting with her sister…

Some seem to see my vulnerability — which I have no choice but to wear openly given my physical appearance — as an invitation for them to share their own vulnerability, whether my relationship with them warrants it or not.

I’ve had people I don’t know intrude on my personal space (yes, I know my fuzzy hair is awesome, but that does not mean I want strangers to randomly start rubbing my head). At a BBQ a while back I was enjoying some quiet in the garden, daydreaming and staring off into space, when a woman I had just met (but who knew I was sick), came up to me, started rubbing my back, and asked me, dramatically, “Are you okay?

Caught off guard, I bristled back, leaned away, and promised I was fine — anything to get her to stop rubbing my back as soon as possible — but this just made her more insistent. “Are you sure??” she said, rubbing even harder.

These moments all share something in common: I am treated not as a person, but as an object. I am used, probably subconsciously, to serve another person’s emotional need without consideration as to how I might feel about it.

Others will turn my illness into their illness, as if being around cancer is anything remotely close to having it. In a text just the other day, a person I am no longer close with, while telling me how much harder my sickness has been on him than me, referred to my cancer as “cancer” — yes, with air quotes — as if I have the fake kind of cancer, and this is all just one big spa vacation for me where I get to relax on the couch while models in greek togas fan me and feed me grapes.

I did not realize before I was sick that self-awareness is a quality many people go their whole lives without developing; I did not realize age does not guarantee wisdom (Nor does youth preclude it; in fact, almost all of the boundary violations and odd comments I have witnessed have been committed by people decades older than I. My friends and peers have generally demonstrated a compassion for my situation that is impressive given their lack of experience with it). And the realization that naturally comes out of these points is that not everyone is equally deserving of my (currently limited) mental and emotional energy.

It is not a moral issue of some people being good and others being bad; rather, some people are highly evolved and others are not.

Those who said cruel things to me when I first wrote about my cancer diagnosis, speaking from a place that I now realize was utterly self-involved (how else could a person justify saying such harsh things to a young woman when she had so much taken away from her just days earlier?) — at the time, they devastated me. I felt their opinion mattered as much as those strangers who were so kind and supportive. But now I care much more about what I think about people at that stage of development than what they think about me.

On the other hand, there have been so many who have illustrated that true generosity and selfless love are possible. My friends and family who have visited or sent kind messages weekly, dropped off food for me, told me they will be there for me in any way I need (and when they say it I know they will); teachers and employers who have given me the gift of focusing on my health and not worrying about work; my cousin who took me in when I became homeless and treated me like her own sister.

These people hold a space in my heart. Their opinions also hold a space in my mind.

The least self-aware people don’t learn from their own experiences, repeating the same mistakes when they are older as when they are younger. Others, who are more wise, learn from their experiences and grow in self-awareness over the course of their lives. The most wise people learn not only from their own experiences, but from the experiences of others — they learn from the experiences of history.

I look forward to the day when having cancer isn’t the first thing I think of when I wake up, when it doesn’t consume me throughout the day, when the most salient thing about me isn’t the fact that I am sick. Until then — at least I’ll learn a lot.

diploma

Comments

  1. Ellen Lanser May says:

    Elana,
    Yes, yes, yes. You’ve articulated precisely what I’ve been struggling with the past two months as people react to me–a “youngish” woman facing cancer…and I’m surprised/relieved at how simple it’s been for me to recognize instantly those who treat my cancer selfishly. And I’ve been disappointed by those who have been angry at unreturned phone calls and texts. It’s my second bout of cancer…I underwent a liver transplant 12 years ago at the age of 31 to cure a freakish liver cancer. And now I’m facing a mastectomy on July 14th to hopefully cure breast cancer.
    I am grateful for this post–I’ve been too afraid to express exactly what you’ve described for fear of being seen as ungrateful. Reading this has been incredibly cathartic. THANK YOU.
    Ellen

  2. Kathleen says:

    You said what needs to be said. Thank you!

  3. Valerie Weber says:

    What a great post. Thanks for sharing your journey. I saw a funny meme today…it was a picture of a woman sitting at a typewriter. The caption read, “Dear whatever doesn’t kill me, I’m strong enough now! Thanks. ” Maybe you can relate? Lol. hang in there.

  4. Élana,

    Your writing is honest and says so much about your journey. My experience comes from being the other who offers love, support without expectation. I appreciate your very eloquent reminder of how important selflessness means in difficult times. Our paths won’t literally cross but in my heart your words touch upon what is most important for me in offering love and care to my partner as she transverses through treatment and all that cancer brings into our lives.

    My best,

    Lori

  5. Jennifer says:

    Hi Elana, Congratulations on almost graduating! I know how challenging it is to finish residency with a diagnosis of cancer. I’ve experienced many of the same comments from friends and family. People have definitely shown me their true colors over the past 12 years. Some can be supportive, some can’t. Just as you express, I am truly grateful for all those who have been there. I am sending many healing thoughts your way. Take good care. Thanks for sharing your journey.

  6. Elana, I was thinking of you yesterday and hoping for an update. Your raw honesty is amazing and filled with truth. I am thrilled that you received your almost diploma. I have a daughter who just finished her second year of med school and I am becoming aware of the intensity and difficult path becoming a doctor is. I came across your blog before your diagnosis and was so impressed with you that I immediately told my medical student daughter about you. I would hope to not be in one of those categories of people that have a hard time knowing how to be around you but you know it is not surprising that there are a lot of people who do not know how to be in the face of disease. I am also a mother of a daughter with CF and have been in the chronically ill world for over 30 years now. There is only a handful of people who can truly acknowledge the pain, the disruption and the grief that comes with serious diagnoses. And with this understanding that has grown from your experience you are going to be an amazing doctor and teacher. We all need to learn to be with disease, disability and death. It is a part of life, especially the death part, no one escapes that one. I send my love to you, my awe at your strength and ability to tell the truth and courage to put that foot in front of the other everyday. I will be looking for future posts. Your words make me grow………….

  7. Susan McCreight says:

    Hi Elana,
    Congratulations on your certificate! It’s nice to have that affirmation of all your hardwork.
    Fuzzy hair is at least hair on its way back. I honestly had to chuckle at the person trying to rub your head — and a stranger! Gee, people can be astonishingly unaware of what is just plain inappropriate.
    Overall, you sound better than the last couple of times you’ve written something. I’m glad for that. I know all about those people who want thank you notes and calls of thanks. When I was at a very low moment, someone brought me a bag of groceries (unrequested) saying she thought I’d probably feel better if I got up and cooked a meal(!). I laugh about it now but it really threw me at the time.
    I’m hoping each day brings you a little more comfort, a little less stress, a little more energy.
    I think of you often.
    Susan

  8. Lynn Blaney Hess says:

    Someone actually asked you, “Where is my thank you card?”?????? Holy Hell! Someone lost the empathy Lotto!

    I’d wager a guess that you have more insight into the human psyche because of your cancer than anything you could’ve ever learned in your psychiatry program.

    I can’t even offer fake generosity, because we’re strangers who don’t live anywhere near each other. But I can offer love and energy and a virtual hug. Thanks for showing up despite it all.

    • Ellen Lanser May says:

      It’s amazing….during my second bout with cancer (after undergoing fives surgeries) someone asked me why the only time she and I talked seemed to be when I had cancer or surgery (and btw, she was the one who called ME!!!). Most people are by default good. But those negative, narcissistic folks can really hit you with a sucker punch when you’re already down.

  9. Thank you for sharing your observations and insights. Be well.

  10. Beautifully written. Thank you for sharing your journey. My hardest thing when I got cancer was people telling me that I had one of the best kinds to get. Can that even exist. I told them if it was so easy then they should have cancer. Seriously who tells you that oh you have cancer but it is a good one to have! Oh my!

  11. Charlie M says:

    I just love the way you write and your honest, eloquent and thoughtful essays. As a volunteer who supports trauma victims in the first hours afterwards, I can attest that people say all kinds of hurtful things that they mean to be helpful. (“God wanted another angel,” they say to the mother of a 3-year-old killed by a drunk driver. I don’t even know what that means.) Many don’t know what to say at all and they stay away. It’s rare to have a loved one or stranger know that a listening ear and a loving heart are far more helpful than any piece of advice or platitude they can quote to “fix” your pain.

    Many hugs to you from afar. Your courage to be honest is breathtaking. Truly.

  12. Erin Maynard says:

    What you write trancends any one illness or health issue. It resonates so clearly with me as someone who has watched hundreds of people struggle with mental health issues in my role of a non-profit coordinator. Thank you for so eloquently talking about the burden others place on those who struggle with long-term health issues of all sorts.

  13. Dear Elana, your raw honesty touches me to the core. Thank you for being real, for saying how it is. My thoughts and prayers are with you as you continue on your healing journey. I celebrate you and your feeling about the diploma you received. May it be a shining light on the wall of your office space one day. I heard your heart’s voice today, and it is a powerful voice. I just wanted you to know my own heart was listening. May your healing be swift and complete!

  14. Mindy Pannell says:

    What can I say…you articulated what my heart has been trying to understand. I went through a three year battle with a septic joint & osteomyelitis, involving 25+ surgeries. The conditional (transactional) generosity was incredibly hard for me to deal with. I lost a couple people in my life because they forced their generosity on me, despite my protests, & then they were furious when I didn’t follow their medical advise, instead of my medical team’s. Thank you for your raw honesty….your willingness to be vulnerable gives me hope.

  15. Hey Elana, congrats on graduating. Rad diploma!

    I’m still trying to absorb what you’ve written here. It’s shocking, jarring. But thanks for writing it. I’m pretty sure I’ve been guilty of some of those “conditional generosity” actions at different points of my life. Hopefully people can come here, read this and look at themselves more critically, if they are guilty of such things.

  16. Elana,
    I have been blown away by your posts and today’s was no exception. I love the honesty and the raw vulnerability you express from. I look forward to each thing you write, including the one where you said you were too depleted to post anything. That really pierced me as I thought to myself… “She’s being apologetic for not being able to write!!” That’s crazy. You don’t owe your readers anything. I feel privileged to hear your journey. I have absolutely nothing instrumental to offer you but if my thoughts and wishes for your complete recovery have any energetic impact, then maybe what I do helps. I have wanted to comment before but have felt stuck because I don’t do cliches or platitudes. I don’t know you but I want you to know that I’m rooting for you like hell. Keep fighting. Kick cancer’s ass!

  17. Hi Elena,
    I am so happy to hear your voice again, I have missed it. I have read everything you said and tried to take it all in. How must it feel to be you going through this at such a young age, And with the insight you have gained from your training added to the intelligence that you obviously bring to this discussion you make many points that have taken me and probably most people much longer to learn. Most people are good but even good people are self absorbed. In fact most people will never gain the self awareness that you had probably even before you had cancer. I try to be compassionate towards such people because they simple don’t get it and most likely never will. Cliches flow freely, stories revolve around their more “important” lives and they often have tit for tat expectations. Your cancer just brings these faults to the foreground like moving a layer to the front in photoshop. And Elena you are a magnet for all the things people have said or done because they had no idea what to say or do. One of the reasons I am reading this blog is so that I can learn what is we can do to help our friends who might need our help one day.I hope you write more about this topic. I am trying to learn from your experiences.
    Feel better sweet Elena.
    k

  18. This is a really profound insight – thank you! I found it similarly articulated in this TED talk about disabled people being used as inspiration for non disabled people:

    http://www.youtube.com/watch?v=SxrS7-I_sMQ

  19. Dear Elana,
    Thank you for your post. In February, my Partner was diagnosed kidney cancer. He got surgery and he’s well again now but this experience gave me some insight of all that you are mentioning in your post, all these different behaviors people show, the nice words, the stupid ones, the useless and the comforting ones, the attitudes which makes you want to scream, the “selfish kindness” and the true concern, the small things like a silent simple look in the eyes, a simple pressure of a hand on yours which can mean the world to you.
    Being in Europe, of course, I can’t help you much. I won’t give you any advice because who am I for doing such a thing? I’ve not experienced cancer myself, I’ve just been a witness to what my Partner was going through, doing my best to shelter him and protect him and support him. I won’t tell you such stupid things as “God only gives you what you can face” (how meaningless!). I can only tell you that I understand what you are going through. I understand the rage and the disappointment, the pain in your soul when you discover that the people you thought you could relied on, simply “disappeared”.
    The only positive side I can see to this shitty period right now is the cleaning in our life: we got rid of people we called “friends” but who were obviously not, we refocused on a smaller group of people who were really there when we needed them, we know now who is truly a meaningful part of our life, who is sincere and caring and loving. It’s like a big “soul Spring cleaning”, like after a violent storm. All is clean and fresh. I feel our circle now is only made of people who have a beautiful soul. This can seem trivial but for me, it seems like we start anew, with new real, stronger relationships in our life. And this makes us feel also stronger to face this period in our life. I hope it will be the same for you. When you will be receiving patients later and they will face the same horrible sickness as you are now, you will know what to tell them, how to reassure them, how to help them go through the ups and downs. You will be precious to them, just like these caring people around you are precious to you right now. I wish you good, I wish you well. I admire you for your strength and your will. Though I do not know you, and I hope you won’t mind, I would like to send you a big hug today. Take care. I’m thinking of you.
    No need to respond.

  20. Dear Elana,
    Thank you for your post. In February, my Partner was diagnosed kidney cancer. He got surgery and he’s well again now but this experience gave me some insight of all that you are mentioning in your post, all these different behaviors people show, the nice words, the stupid ones, the useless and the comforting ones, the attitudes which makes you want to scream, the “selfish kindness” and the true concern, the small things like a silent simple look in the eyes, a simple pressure of a hand on yours which can mean the world to you.
    Being in Europe, of course, I can’t help you much. I won’t give you any advice because who am I for doing such a thing? I’ve not experienced cancer myself, I’ve just been a witness to what my Partner was going through, doing my best to shelter him and protect him and support him. I won’t tell you such stupid things as “God only gives you what you can face” (how meaningless!). I can only tell you that I understand what you are going through. I understand the rage and the disappointment, the pain in your soul when you discover that the people you thought you could relied on, simply “disappeared”.
    The only positive side I can see to this shitty period right now is the cleaning in our life: we got rid of people we called “friends” but who were obviously not, we refocused on a smaller group of people who were really there when we needed them, we know now who is truly a meaningful part of our life, who is sincere and caring and loving. It’s like a big “soul Spring cleaning”, like after a violent storm. All is clean and fresh. I feel our circle now is only made of people who have a beautiful soul. This can seem trivial but for me, it seems like we start anew, with new real, stronger relationships in our life. And this makes us feel also stronger to face this period in our life. I hope it will be the same for you. When you will be receiving patients later and they will face the same horrible sickness as you are now, you will know what to tell them, how to reassure them, how to help them go through the ups and downs. You will be precious to them, just like these caring people around you are precious to you right now. I wish you good, I wish you well. I admire you for your strength and your will. Though I do not know you, and I hope you won’t mind, I would like to send you a big hug today. Take care. I’m thinking of you.
    No need to respond. Hélène from Switzerland

  21. People are a strange lot. I love your certificate. I look forward to reading your posts. They are insightful, sometimes so very sad, and then full of strength and hope. Thanks for sharing.

  22. Beautifully observed and reflected. I am an oncology RN. I agree 100% with your assessment. There are very few enlightened beings among us. Those who are are like gold. Keep moving ahead sister. Love and peace to you.

  23. sandy fobb says:

    Wow. You should get credit toward your diploma for your experiences right now ! You have been learning from it and documenting , right ? At any rate I would like to congratulate you on your almost diploma . Pat yourself on the back and mentally throw that cap in the air or whatever – you know what you have accomplished and although it was made even more difficult by sucky cancer your goal is in sight . I think you are going to be an insightful , compassionate and HONEST doctor and I would go see you ! (and I have a profound distrust of psychiatry in general)

  24. Only a cancer patient understands another cancer patient. I myself was once where you are now. One of my clients told me that I was going to be just fine. I said nothing. 8 years later she has stage 4 cancer and if anyone dares to tell her that she is going to be just fine she wants to scream at them. You were once an advocate of positivity. You did not understand what it truly meant to hang onto life by a thread. Now you do. All those people who don’t have the right thing to say to you are like who you used to be. Cancer sucks but it brings great understanding. p.s. before I had cancer I used to hide from cancer patient friends. The uncomfortableness of it was unbearable. I embrace cancer patients now because I have a connection. I know what they are feeling and what they need to hear and not hear.

  25. My husband was diagnosed with cancer a couple of months ago. Since then, our life has deeply changed in small and big things. I’ve read your article with deep interest and compassion…and, among other things, you’ve thought me that RESPECT would be one of the best attitude we can have towards who is sick and we love.

  26. Elana,
    When I was diagnosed with breast cancer 13 years ago, a friend called and said, “My heart is broken.” I still cherish her, and those words. Congratulations on your graduation and on your ability to project forward to the moment when you will hang the diploma on your wall.
    Keep fighting!!
    Carol

  27. Wow! Thank you for the honesty of “On Human Nature.” I want to remember it when I talk to a friend or colleague with such problems as yours or really, anything they are struggling with. I want to be helpful if I can, not insensitive.

  28. “… self-awareness is a quality many people go their whole lives without developing…” YES! BRILLIANT. You told it like it is and it needed to be said. I enjoy your posts and I’m thinking of you.

  29. Elana,
    I enjoy reading all your posts, Congratulations on your almost diploma! Love how honest you are and so strong, you tell it like it is! I look forward to reading your posts, Thank you for Sharing!

  30. Thank you for sharing what you are learning from your cancer experience, and congratulations on your almost graduation.

  31. Carol Warren says:

    I had one person tell me how much she appreciated me making my cancer diagnosis so easy for those at work…..well heck that was my goal, forget about me, just don’t make anyone feel uncomfortable cause I’m bald and only have one boob. But you know I laughed it off as I could not waste my energy on it. It is interesting to see the responses, I chose just to try to laugh it off.

  32. Congratulations Elana on your almost diploma!

    Thank you for your words of wisdom. I don’t feel as guilty now for the calls and e-mails I didn’t respond to over the last 7 months of surgery and chemotherapy.

    In my evolution in this journey I share the following lesson I learned:
    My primary Specialist oncologist is in a city about 4 hours away from where I live. Before I started chemo I thought I would have to be traveling back and forth to receive treatments, until several people suggested that I could have treatments in my hometown and still have My specialist oversee it. So my husband made an appointment with the local oncologist to discuss options. The next time we saw our specialist we talked to him about the expense and stress of traveling back and forth and asked if we could have treatments where we live. Though he said it wasn’t the best, he understood and instructed his nurse to arrange to meet our local oncologist. The nurse came back saying we already had an appointment and my husband and I read by his remarks that our Dr. was upset that we had already moved ahead with exploring our options. My husband couldn’t stop thinking about it and for two days he worried that our Dr was angry with us and so finally he wrote the Dr. an e-mail apologizing profusely about our oversight in telling him about the appointment we already had and that he feared that we had compromised our Dr. / Patient relationship. 15 minutes after sending the e-mail we got a phone call from the Dr. saying that the apology was unneccesary. “This isn’t about me. It’s about you,” he said. My husband cried with relief and I got a cancer classroom lesson that it was okay to look after my own needs and put myself first, including not trying to carry the burden of how everyone else thinks and feels about my having cancer.

    You are an amazing woman with so much insight! Thank you for sharing it with us. I learn something new about the way I think and feel everytime I read your posts. They stir me to go deeper into my own stuff and work to sort out the junk and keep the gold.

    Cheryl

  33. Elana, I was the lady giving you the back rub and you totally misread the situation, I was trying to come on to you! Not everything is about your cancer, Elana!!!

    Okay, I’m kidding but here are some of the stupidest and greatest things I said to my friend who was dying of cancer. When they told her that after ten years of cancer “this was it” she had run out of options I said: “Oh man, that’s pretty fucked up.”

    Or when they told her she had about three days left, I cocked my head, patted her foot and said: “Well, no one can say you haven’t really lived. You’ve had a great life.” She sighed and said “Yup,” but with her eyes she communicated that if she had the strength she would jump out of bed and bitch slap me.

    And here were the very last words I spoke to her as we hugged and cried goodbye: “Well, see you on the other side! If such a place really exists.” And then I actually said, “Heh heh.”

    My friend who had anal cancer (she calls it ass cancer) told me that the best thing I ever did for her during that time was when she called and said she was too nauseated to drive. Apparently, I didn’t even let her finish the sentence and said, “I’m on my way.” I didn’t even recall doing that. Of course if I remember correctly, I’m also the one who told her to stop whining and take an Uber to chemo. So, like most people, sometimes I’m brilliant, sometimes I’m stupid and thoughtless, but that’s not just in the face of cancer, that’s every day of my life. My advice to you is when confronted with morons who try to pat your head or give you back rubs, carry a taser. One of the benefits of having cancer is that no one will send you to jail.

  34. Marianne G. says:

    Thank you for sharing, I appreciate the insight.

  35. Lindsey says:

    This post really opened my eyes to what giving is. It reminds me also of that book “The Circle” by Dave Eggers, great book about human selfishness, paranoia and totalitarianism. It’s like a modern 1984. Anyway, thank you. My heart goes out to you.

  36. Perhaps, go back to your first post that captured the hearts of so many – and re-read it in such times of despair. Think back to ALL those people that came to your rescue. And know , for every person that doesn’t return your phone call, there are 5 people who don’t even know , that read your post the first time, were inspired by your positivity and praying for you.

    I wish the best for you.

  37. This is knowledge many seek to understand, yet it is elusive to SO many. I’m so glad you learned more in six months than in 12 years. Coming from a 15-year sentence working in a psych hospital, I have to say how SICK psychiatrists, psychologists, and psychotherapists are (in my very limited, 15-year experience). You are light years ahead of the pros, bright one, and I sincerely hope your immune system going forward is able to ward off all cancer cells in your body so you are able to truly, clearly, cleanly, effectively do the work you’re here to do. YOU GET IT, now bring it forward into the world. So very few are able to do that! Rock on, bright one.

  38. Congratulations, Elana! You have worked very long and very hard for this. I am so glad you are celebrating this momentous occasion! Every celebration is another victory that you are living life well. And, I am doubly proud of you for not letting the last 6 months and your cancer diagnosis derail you and that you have stayed the course, done what you could, and foraged ahead! It is inspirational for me, and, I am sure for all of us that are watching and cheering you on from afar in all that you have undertaken and accomplished. You are an amazing young woman! It is with such pleasure that I read your blog, following the good, the bad and the very ugly that you write so eloquently, honestly and gracefully about. You have a real following that you inspire with your writing……..I am sending healing thoughts, as well as, very sincere congratulations to you. Keep doing what you are doing because it is working!

  39. jdubyba says:

    there would be no such thing as psychiatry if people were not terrified by death and dying; that’s no consolation, i know, but in addition to your almost m.d., you have a phd in suffering; if/when you can read, try The Wave.

    i like the advice “no need to reply.” i hope every day has some light for you.

  40. Thank you so very much for this post!! I’m almost 8 years in remission and still think about how others reacted during my treatment period. It really helps you realize who your true friends are. I love your professors’ kind gesture of the “almost” diploma! :)

  41. You are good at tough love. You use the “bad” things as an opportunity to teach and enlighten, to help others become aware, and improve themselves and the quality of life of others.

    You make me think about myself, and question whether I am doing “the right thing.” I thank you for doing it.

    Your experiences are a part of you. Many people will expect you to “put things behind you”, and won’t understand things you say, or feels. Because you are a caring health care provider, you will feel pain when you reach out to others who need your help, yet reject it because they cannot hear. Your compassion will be even greater.

    What do we do with this thing called life? How do we know if we are doing the right thing? What does it mean to be a good person?

    Please keep writing. The people you move most likely won’t be able to find the words to thank you.

    So, thank you.

  42. Elana, from your notes I have learned a great deal about how to be compassionate and assertive with those around me.

    I won’t pretend to know of any particular plan for you, and I doubt there’s anything I have to offer. But as a physician and a writer, your documentation of your illness has touched me and many others. Thank you.

  43. Surag Gohel says:

    Hi Elena,

    Congratulations for your graduations. It’s glad to know that you are doing well. Thanks for sharing your experience.

    Take care of yourself.

  44. I like that diploma! I’m impressed that you have done as well as you have with many of these misguided individuals.

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