An excerpt from From Both Sides of the Curtain: Lessons and Reflections from an Oncologist’s Personal Breast Cancer Journey.

The mammography waiting room always played HGTV. I had been in this space countless times before, having started routine screening at the age of 40. I always booked the first appointment of the day because I knew all too well how easily schedules could get backed up. Like clockwork, the tech called my name soon after I checked in, and within minutes my breasts were being pressed between two plates of the X-ray machine. Once she had obtained all the necessary images, she directed me to wait in a holding room while Tim, the breast radiologist and a longtime colleague, looked at my images. She returned a few moments later and led me to his office, which was hardly concerning because he always reviewed my scans with me. What was concerning? That he couldn’t meet my eyes.

“You have a new area of calcifications in the upper outer quadrant of your right breast. It wasn’t there last year,” he informed me as he pointed to a large number of scattered white dots of varying shapes and sizes on the computer monitor.

I reviewed the images and agreed. “Yes, I see them. Well, at least there aren’t any masses,” I sighed with relief, as I assumed the irregular calcifications were likely ductal carcinoma in situ, aka stage 0 breast cancer, which is easily treatable.

“No definite masses,” he agreed. “But there is an area of asymmetry. We need to do an ultrasound to get a better look.”

The warm ultrasound gel on my breast felt jarring against the cold air of the exam room. I tried not to look at the screen, tried not to interpret the clicking sounds of the tech capturing images or the silence that followed each measurement. But 15 years as a radiation oncologist made it impossible not to understand exactly what was happening.

That’s when he delivered the news: 5 masses in my breast, the largest being 3.6 cm, and an abnormal lymph node too.

My world fell out of focus for a moment. 3.6 cm echoed in my head. How did I not feel something that big? My doctor’s brain immediately started predicting tumor biology and calculating growth rates while my mother’s heart seized with panic. What about my boys?

I was moved to the hallway of the radiology department, where I sat while they prepped the room for a biopsy. As I was trying to process what was happening, one of the techs approached.

“Your patients love you so much. They also talk about how nice you are. I’m sorry this is happening,” she said softly. “Can I give you a hug?”

I wanted to scream. Nice? I didn’t want to be nice. Nice people died. I’d seen it too many times in my own practice: the kindest patients, the ones who never complained and were more concerned with others even as they suffered through their own treatment. They were the ones who broke my heart.

Instead, I found myself nodding, accepting her hug.

“This is so unfair,” she continued. “You help so many women.”

I nodded again, not knowing what to say. I knew there was no such thing as fair, especially when it came to cancer.

Calling for help

I needed to talk to Devina. She was one of my best friends, my sister in everything but blood, and one of the busiest breast surgeons in Central Florida. We first met when she interviewed with the medical group for an open position as a breast surgeon. During our hour-long one-on-one meeting, we talked about everything but the job. Her oldest son was the same age as my youngest, and we decided they would go to school together and be friends. We picked the neighborhood her family would move into and established that she would get along well with my circle of friends. When she accepted the position and relocated to Florida, all that we predicted came true, and our families grew into one big extended family.

I knew Devina was upstairs in the hospital operating all day, but maybe I could catch her in between cases. My hands shook as I dialed her number. When the OR nurse answered, I cleared my throat and tried to keep my voice steady.

“Is Dr. McCray available?”

“I’m in a case right now,” Devina called out, her voice distant on speakerphone. “What do you need?”

“There’s something wrong with my mammogram.” I could barely get out the words.

“What do you mean?” Her voice sharpened.

“They found 5 tumors.” The sob caught in my throat. “And a lymph node.”

“Get her off speaker!” Devina barked. Then, directly in my ear: “Where are you?”

“Downstairs, in the radiology department.”

“It’s going to be OK.”

“It’s not going to be OK, Devina!” I snapped back.

I could hear her directing her team to finish up, as she promised to come find me. Within minutes, my colleagues were transformed into my caregivers. Wassim, a close friend and breast medical oncologist, placed orders for a battery of tests. He sent his nurse, Chassidy, to keep me company as I waited for insurance to approve the biopsy. She was a quiet guardian who worked in almost every department and knew almost everyone in the hospital. If I needed anything, she would know exactly who to call. When the ultrasound suite was ready, she gave my hand a tight squeeze and mouthed, “It will be OK.”

The biopsy

Once I laid down on the table, I heard a snap as the nurse broke open a chlorhexidine stick and applied the cold antiseptic to the surface of my breast. Tim entered the room, barely recognizable in his mask and scrub cap.

“Let’s begin the time-out,” he said professionally. His need to verify my identity prior to the procedure made me acutely aware that I was no longer a colleague. “This is Sue Hwang. We will biopsy two masses in the right breast and a lymph node.”

Just then I heard Devina in the hallway. She knocked quietly and entered the room. By this time, the first mass was visualized on the large screen overhead. Devina took one look at the screen and said nothing. She grabbed a stool, sat down by my head, and started running her fingers through my hair.

“It will be OK,” she whispered in my ear. “It’s probably nothing.”

But I knew from the tears running down her cheeks that she knew this was cancer. The professional demeanor I’d maintained for 15 years crumbled in an instant. I was no longer Dr. Hwang, the confident oncologist. I was just another scared patient, watching my whole world shift on what should have been a routine Wednesday morning.

Sue Hwang is a radiation oncologist and author of From Both Sides of the Curtain: Lessons and Reflections from an Oncologist’s Personal Breast Cancer Journey.