When Doctor Becomes Patient

Lazy mornings. Sunday roasts. Willow trees. Her husband, Christopher.

These are a few of Kate Granger's favorite things – the parts of life she loves most. She loved them before she was diagnosed with terminal cancer three years ago, but living with the illness has heightened her appreciation of life's simple pleasures.

It’s also made her more aware of what hospital trips are truly like for cancer patients. The visits can be bewildering and isolating, from painful chemotherapy to staffers who forget to introduce themselves before delivering care. As a practicing geriatric doctor herself, Granger has the power to change that experience for other patients. She's made it her mission to make treatment more compassionate, launching a #hellomynameis campaign encouraging health care professionals to interact with patients on a more human level.

Granger was kind enough to talk with Legacy.com about what she’s learned from living with a terminal illness – and how doctors can better serve their patients.

Legacy: What are some things you've learned from living with a terminal illness?

Kate: "Being ill has taught me so much about being a doctor. One of the biggest lessons I've learned is about the patient experience of receiving serious news. As a clinician, you share (news) that's life-changing and often devastating, then you just go back to your own life. The patient is left with that news forever and forced to live with it. The way we share such news is, therefore, of paramount importance for the patient's experience and understanding of the situation.


"I've been on the receiving end of some good 'breaking bad news' communication but also had some very poor experiences. When done badly it can have such a negative, long-lasting impact. It has made me take more time with people, to be more aware of my own body language, to be more attentive to the little acts of kindness that can promote a person's comfort. I've learned a great deal about compassion and how much this matters on this journey, too, but that it doesn't have to involve grand gestures. Someone holding your hand when you're frightened can make a huge difference to how safe you feel, in my experience."


Legacy: What are some specific ways health care professionals can be more compassionate?

Kate: "I will always make the effort to sit down near the patient with an open body posture. This demonstrates instantly to a patient that you have time, you care and you are interested in them. I use silence more now. This is a strategy I've observed my own oncologist using when he's communicating with me. Being quiet gives a patient time to compute what's going on and to release their emotions. I'm also more interested in my patients as people now. For example, when I sit down with relatives to talk about the fact that their loved one is approaching the end of life I will often start with, 'Tell me about your Mum.' Getting to know the person, their priorities, anxieties and fears is so important if true person-centered health care is to be achieved."


Legacy: How has your personal outlook changed in the time since being diagnosed?

Kate: "My outlook has changed massively. I think I'm much more positive and, strange as it sounds for someone in my position, happier. Life has thrown an unexpected trauma at us, but we're dealing with it and succeeding, in my view. So we live by our 'one day at a time' mantra and look forward to our short-term goals. My professional ambitions have been curtailed and I'm never going to become a mother, both of which hurt deeply and are a heavy burden to carry every day. However, I have to be grateful that I am still alive, having massively defied my prognostic odds."


Legacy: Are there any specific daily activities that you’ve stopped caring about since your diagnosis? How about daily activities that you care about more now?

Kate: "I suppose I'm less keen on housework now, although I remain fiercely independent and hate asking for help with it! There is something satisfying about doing the ironing yourself or cleaning the bathroom. Dinner time is more important now. We like to cook a proper meal and sit down together to discuss our days. I appreciate the little things in my day much more now, such as the luxury of soaking in a bath or the beauty of the blossom on our cherry tree. Work is less important to me now in the grand scheme, although being a doctor will always remain a huge part of my identity."


Legacy: What's your favorite part of each day?

Kate: "I think it has to be when I first wake up next to Chris each morning, all warm and cozy in bed, and for one split second everything is perfect. It only lasts a moment before all the cancer and dying stuff comes racing back into my brain, but for that moment I feel safe and loved."


Legacy: If you could change one thing about how you lived your life before the diagnosis, what would it be?

Kate: "I think if I had the chance to do life again I would have been less work focused, spent more time with my family and friends and not given up my hobbies. I was very ambitious before cancer and married to my career; that meant work always came first at the expense of my flute playing, my swimming, my baking, seeing my friends. I'm very grateful to cancer in some ways for giving me the time to resume these important activities that make me who I am. Before illness, I wouldn't see my family for weeks on end, but now I spend time with them much more regularly. I love playing with my nephews and niece, although it is always a little bittersweet as I will not see them grow up into the successful young people that I know they will become."


Legacy: What advice would you give to someone who's just been diagnosed with a terminal illness?

Kate: "Everyone develops their own individual coping systems for dealing with news of a terminal illness. I wanted to make memories for my family and friends – this was my motivation to write a Bucket List very soon after diagnosis. It has given us a special, positive focus away from illness, and as a result we've had some wonderful experiences. I try to enjoy the life I have as much as I can because I know it's going to be cut short. We have a 'three nice activities a week' rule, which means we never get stuck on the treadmill of life, not having any fun. In terms of the medical side of things, I think it is vitally important to spend some time thinking about your own priorities and values in life. Once you are clear about these in your own mind, it really helps you to determine which treatments are right or wrong for you. Lots of palliative cancer therapies, for example, carry a huge side-effect burden, and it may be that you choose that no treatment is the right path. I've had chemotherapy in shorter bursts than my oncology team originally planned, but that has been completely right for me to try and maintain a decent quality of life in between treatments. I've been extremely diligent about my end-of-life planning. I've made a will, written a detailed funeral plan and talked openly about what I would like from my end-of-life care. This was helpful to me at the start of this journey, to be able to say I'd done it and therefore it could be boxed off in the back of mind while I get on with living in the meantime."


Legacy: What advice would you give to the family of someone who's just been diagnosed with a terminal illness?

Kate: "... I'd say although all your energy will seem to be spent supporting the person with the illness, it is vitally important that you look after yourself, too. Caring can be stressful and tiring. You will be hit by all sorts of emotions and reactions, but I think it's important to try and roll with them as they come. If you feel like crying, then cry. If you feel like shouting, then shout. Chris was very angry in the beginning and it took him a long time to move to acceptance of our situation. Make sure you have your own support network to lean on when required. Chris has some fantastic friends and work colleagues, and they've been amazing to him throughout all this. It would be all too easy to shut yourself away from the world, but social interactions can be a brilliant tonic."


Halley Burns is a writer and editor based in Chicago. Connect with her on Twitter at @halley_rosetta.