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The three lessons I learned from cancer

A medical student comes face to face with the most unexpected illness—his own

You never think it’s going to be you.

As medical students, we often get caught between thinking we’re invincible and diagnosing ourselves with the rarest diseases known to man. I remember a lecture during our hematology block where the lecturer told us that, statistically speaking, one student among our class of 171 may get Hodgkin’s Lymphoma. We all laughed.

It would be me.

In February 2016, I was in the middle of my surgical clerkship rotation when a phone call changed my life. A routine chest X-ray, performed as part of the screening requirements prior to starting clinical electives in my final year of medical school, came back positive for “concerning findings.” After a whirlwind of CT scans, a bone marrow biopsy, a needle biopsy and lymph node biopsy of an enlarged lymph node in my neck, the diagnosis was confirmed: nodular sclerosing Hodgkin’s Lymphoma.

There were no external signs of something sinister brewing. I had lost some weight, but still felt – and looked – healthy. And yet, somehow, over the course of six months, I’d gone from being invincible to needing six months of chemotherapy.

Shihan’s medications consisted of granulocyte-colony stimulating factor (Neupogen) taken as 45-50 subcutaneous injections, anti-nausea medication (zofran and dexamethasone) and other necessary medications (sennakot, etc.)

My life stood still. I watched my extremely supportive friends progress toward their final year of medical school while I wondered if I would ever make it back to medicine. But, just like any other trial in life, there were lessons to be learned. The first of which was awareness of my attitude.

“There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.” Dr. Paul Kalanthi, When Breath Becomes Air

I remember sitting in the waiting room of the chemotherapy suite and talking to the partner of another patient. She complained to me about her partner, and how his diagnosis had changed his perspective for the worse, how bleak his life appeared to him. She compared his outlook to those of two other patients she’d run into; both of them had quite different – and positive attitudes – despite their terminal prognoses.

The importance of enjoying life and remaining engaged was not lost upon me. I paid close attention to my thoughts, and tried to maintain the most positive outlook I could. I practiced mindfulness, set goals for myself. Enduring any challenge requires a plan to see that challenge through, and the right lens through which to view it. With this in mind, I was able to keep murky, unanswerable questions like “why me?” at bay.

The second lesson I learned was the importance of living a balanced life. This was always emphasized during my time in medical school, but it was all too easy to get wrapped up in the things that seem immediate and urgent, and forget everything else. The truth is, if you let it, the work will never stop. Taking time for oneself is the only way to have time for yourself. I was determined not to waste the year ahead of me, and invested time in things I felt I’d let slip in my first two years of medical school. I taught myself guitar, painted, and, most importantly, spent as much time as I could with family and friends. Recognizing how important these avenues of support are was critical in helping me overcome the illness experience. This sense of normalcy helped me combat the chemo-induced fatigue, my inability to taste, the nausea, and the burning sensation of phlebitis (inflammation of the veins).

The third lesson was understanding that life begins on the other side of uncertainty.

During my therapy, I read When Breath Becomes Air, the eloquent autobiography written by Dr. Paul Kalanthi, who, in his final year of residency, received a terminal lung cancer diagnosis. I felt connected to many of the themes he addressed in his book, but nonetheless felt like I had a slightly different perspective to uncertainty. This may have been the difference in the severity of our diagnoses, our stages of life, or something else. But his written words and my own experience created an environment of intense reflection. Too much time is spent on staying alive—but not truly living.

For me, the outcome remains uncertain (five years is the amount of time someone needs to remain cancer-free in order to be considered “cured”). I have become determined to do all the things that my mental barriers had long prevented me from doing. So far, this paradigm shift has led to a whole new world of experience, and has given me a richer and fuller life.

When faced with a life-defining moment like a cancer diagnosis, it can be hard to maintain your agency. But so much of how we emerge on the other side of those moments is determined by the lenses we choose—not just for how we see ourselves, but for how others see us, too.

I hope my story will inspire others to recognize that they’re not isolated in their struggles, and to help them remain engaged in their lives no matter how heavy the burden grows. In his book, Dr. Kalanthi wrote: “There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.”


Shihan Rajasingham is an incoming first year resident to the  Family Medicine Program at the Schulich School of Medicine  and has been attending Western University since 2009. He spends his time outside of medicine being a passionate painter, musician and photographer. Since returning to medicine in 2017, he has developed a keen interest in hiking, camping and dark-sky gazing.