She was sitting there when I entered the doctor’s office: armed with notepad and pen, flanked by three neighbors, which immediately filled the room. As with our previous meetings, the atmosphere was light, familiar and cordial. Sanne’s warm voice and friendly greeting did not reveal her fear and sorrow for the fact that she was here again.
Tessa Posthuma de Boer, commissioned by NEMO Kennislink.
Less than two years earlier I had gone through the breast cancer treatment process with her. She then quickly faced the reality that she had breast cancer. Where most people don’t let in too much information with that news, Sanne was hungry for information. She had a great need to be able to place the disease and the treatment process in a scientific context. Her questions were challenging and businesslike.
Also this time, when the cancer returned in the treated breast, Sanne retained control over what happened to her and how she wanted to be treated. She had read well and asked sharp questions. She was open to the answers and thereby adjusted her own vision. She liked to take her loved ones to support her, but clearly remained the owner of her story.
For some people, a notepad and pen is a line of defense that is thrown up to avoid the emotion. Not with Sanne. When I asked her how she felt, the scientist disappeared into the background and suddenly Sanne sat there: warm, soft, vulnerable and sad, but with fighting spirit. She was open about her anger that the illness had come back, but after briefly expressing it, she preferred to focus on the solution.
In the many years that I practice, I have seen the most diverse reactions to bad news. The pace at which people go from denial or disbelief to anger, negotiation, sadness and finally acceptance is very different. Everyone’s emphasis is also different. Where one person’s disbelief lingers for a long time, the other anger or sadness is much more prominent. Very rarely, acceptance is quickly reached in humans.
Sanne had already made her treatment choice at home. She came to test it with me. She was determined to fight for the victory over her illness. And we fought together! Never before had I encountered such an aggressive breast cancer image in 22 years of practice, which initially continued to cause problems in both breasts and in the local skin.
Still, Sanne continued to study scientifically what was still feasible on an experimental level, even when the battle was ultimately lost due to metastases in the rest of the body. She fought to receive new, unregistered drugs. Of course with her weapons: pen and paper. She wrote to the pharmaceutical industry to convince them that she was a suitable candidate.
In one of our last conversations I also showed Sanne my grief and vulnerability and expressed my hope that she would, in what was clearly the last phase, come to acquiescence, so that she could enjoy her and her dear husband, daughter, family and friends. I hoped that by accepting impending death she could share the love she felt with them. She reassured me, “I know I’m dying and I accepted that. I love my loved ones. I can really enjoy them. But I need action because it keeps me going. That’s just the way I am. ”
Sandra Donkervoort. Surgeon, OLVG. Amsterdam