In 2016, Theresa Brown, RN, wrote The Shift: One Nurse, Twelve Hours, Four Patients’ Lives, a vivid real-time description of an oncology nurse’s standard 12-hour shift on a hospital cancer ward. It was an excellent book, which was reviewed on these pages and highly recommended for readers of The ASCO Post. Now, some 6 years later, Ms. Brown has added another notable title to her name, but this is the one book she never would want to write: the story of when she became a patient with cancer.
In the short introduction to her memoir, Healing: When a Nurse Becomes a Patient, Ms. Brown describes waiting for the results of a follow-up ultrasound after a questionable finding on a previous mammogram. When the radiologist tells Ms. Brown that she saw a mass, the former oncology nurse and hospice nurse asks whether it could be a fibroid adenoma, as she’s had them before. Ms. Brown relates the rest of that exchange with succinct shock.
“No, she said, gently shaking her head. This looks ugly. The radiologist left, and as soon as I heard the door latch, I sat up and sobbed, my whole body shaking…. My nurse-self had abandoned me, and I had become a patient. Not just any kind of patient, either, but a cancer patient.”
Tough Luck With the System
Healing is a concise book, and as was Ms. Brown’s previous work, The Shift, it is written in muscular prose, with nouns and verbs and declarative sentences, making for a compelling narrative that gallops along in short chapters, each with the clarity of a short story. In part one, Ms. Brown gives readers a brief glimpse at her past as an oncology nurse and then quickly segues back to her new reality, having just been told that the mass in her breast was very concerning. The radiologist had assured Ms. Brown that she wouldn’t leave the hospital without an appointment for a biopsy; however, the scheduler was inadvertently gone for the day, leaving Ms. Brown in an emotional lurch and very angry.
“My nurse-self had abandoned me, and I had become a patient. Not just any kind of patient, either, but a cancer patient.”— Theresa Brown, RN
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“Hearing I’d just missed her, I wanted to slam the receptionist into the wall…. I wanted to punch her in the stomach and as she doubled over, gasping for breath, smash my fist into the bridge of her nose….” There’s more, although you get the point. Ms. Brown, a seasoned medical veteran of the down and dirty trenches of the oncology nursing profession, had just experienced a medical slight, and she was furious. Readers will obviously pause, realizing that over the course of her career, many of her own patients probably suffered equal indignations.
On the day she finally undergoes her biopsy, Ms. Brown devotes several pages to the procedure. She says that although it’s called “routine,” there is nothing routine about cancer, even when it’s still in the “suspicious” stage.
Diagnosis Without Emotional Support
About one-third of the way into her memoir, Ms. Brown is diagnosed with estrogen receptor–positive/progesterone receptor–positive breast cancer. Ms. Brown’s being an oncology nurse adds another interesting layer to the stark clinical diagnosis, as readers anticipate her reaction. She does share the universal sense of shock and loss, as she writes: “Modern health care saved me, saved my life, but Theresa the person got lost…. The soul, or whatever one calls that single essence that makes each of us who we are, needs tending; mine did.”
Then a rather baffling section follows: “All I wanted after my diagnosis was for someone involved in treating my cancer to sit down with me, look me in the eye, and explain my diagnosis; discuss what my prognosis looked like; and clarify my likely course of treatment.” Many readers of The ASCO Post may be left scratching their heads; what Ms. Brown just described is certainly not the norm in the oncology community, where the overwhelming percentage of oncologists spend as much time as necessary to make sure their patients with cancer are fully informed and actively involved in treatment decision-making.
Excellent Care but More Tough Luck With the System
As Ms. Brown takes readers through her treatment regimens—surgery, radiation therapy, chemotherapy with tamoxifen—she also adds short reflections from the past, or anecdotal musings, usually at the beginning of each chapter. This technique, if done with skill and proper selection, might add valuable color detail and texture to the narrative. That said, some of Ms. Brown’s extras seem out of context, unmoored from the story itself.
For instance, when Ms. Brown is about to start tamoxifen therapy, she begins with an aside about her father’s Tam, short for the well-known Scottish wool cap, the tam o’ shanter. It doesn’t work, and she should have known better.
Title:Healing: When a Nurse Becomes a Patient
Author: Theresa Brown, RN
Publisher: Algonquin Books
Publication Date: April 2022
Price: $28.95, hardcover, 272 pages
Another surprise comes when she arrives for breast surgery; once again, she is the victim of shoddy scheduling and a front office that seems at loggerheads with high-value medical care. “I had not understood that indifference [by the front-desk staff] can become a form of cruelty when one’s life is at stake,” Ms. Brown writes. Readers will empathize with her bad luck in the health-care system. Along the way, she does a good job explaining the undue stress of getting proper pain meds, in this new era informed by the prescription drug epidemic.
Near the book’s end, Ms. Brown writes: “For the first time since my diagnosis, I stepped out from cancer’s long shadow and felt able to envision a post-cancer life.” Thanks to advances made by dedicated cancer specialists, Ms. Brown joined the nearly 18 million Americans who are survivors of cancer. This book is not without flaws, some of which could have been spared by a more diligent editor. However, Ms. Brown’s book is worthwhile and is recommended for readers of The ASCO Post.