What does one do when one is a healthy medical student, enjoying classes,
in a great relationship, with beloved friends and a profession that brings
great happiness—and suddenly one learns that one is carrying a genetic
mutation that is associated with a greatly increased cancer risk? For a long
time after I learned my status, I grieved for the life I once thought I had.
I kept trying to remind myself I was not actually sick, although the line
between health and illness certainly had become blurred. It is true that I
am perfectly healthy, yet 2 weeks after learning my status I had my own oncologist
and breast surgeon, underwent my first mammogram and breast magnetic resonance
scan, and had my first biannual transvaginal ultrasound. I was weighing the
options of having children (My doctors: "If you want them, you need to have
them soon"), of prophylactic surgery ("Your best option at this point is prophylactic
bilateral mastectomies and oophorectomies by age 34"), and worrying about
the uncertainty ahead ("Surgery will only decrease your inherited risk by
90% for breast cancer, and 50% for ovarian cancer, because women with your
mutation are also prone to primary peritoneal carcinoma after oophorectomy").
It was time to reorder my priorities. Quickly approaching the end of my 20s,
I made the choice to postpone my medical training to start a family. I was
suddenly part of the world beyond the white coat—the world of most people,
who can no longer look at disease as a professional challenge, but as a potential
path for their own future. Between the sick and the well is the uncertain,
and that is where I now found myself.