From Care Provider to Caregiver
It was February 2019, I was an intern finishing up my last semester of clinical placement in the oncology focus shift at the Integrative Cancer Centre in Toronto, Ontario. Everything seemed like it was fine until it wasn’t. My mom’s first mammogram (at age 50) showed a lesion with the words that I was already familiar with because of the numerous hours of patient visits I’ve had already, explaining their ultrasound and mammogram reports to them. Words like “architectural distortion”, “clustered microcalcifications”, and “spiculaions” were used in the report and I knew it wouldn’t be good news when we went to go see the surgeon.
The surgeon confirmed my suspicions of malignancy, but since it appeared relatively small on imaging, everyone was relieved because we had thought we caught it early. During the lumpectomy, the surgeon discovered the tumour was actually hiding along the walls and was about 4x larger than what was shown on imaging. A week later, a body scan was completed. Another two weeks later, we met with the medical oncologist where he explained the cancer had metastasized to most of her bones.
Within the span of a couple of months, I quickly and unknowingly transitioned from the role of a health care provider to a caregiver. My sister worked abroad so it was just my mom and I. On the weekdays, I would be counselling my patients who have cancer, giving them recommendations, and being their sounding board and on the off days, I would be accompanying my mom to her appointments, blood draws, and hormone injections and drips.
As a healthcare provider now, I catch myself talking to my mom as if she were one of my patients and not as my mom. In other times, the complete opposite will happen, she’ll ask me something and I’ll passively brush her concerns aside, not taking them as seriously as I would if a patient had asked me. A year later, I am still navigating what I am finding to be the second-most difficult (most difficult was definitely us finding out she was stage 4) part of this process as a healthcare provider and caregiver. I straddle the line of being the “perfect” daughter and the “perfect” naturopathic doctor (I know, I know – there’s no such thing!). And like many caregivers, guilt is a recurring feeling/state of mind. I personally find that I end up feeling guilt on two fronts: the daughter front, and the naturopathic doctor front.
“Am I doing all I can as her daughter?” “Should I be giving her more advice and guidance because I’m a naturopathic doctor?” “If I take time off work to accompany her to an appointment, am I letting my own patients down? If I don’t, am I letting her down?” The list goes on.
As I am still figuring this out, I recognize that trying to balance these two aspects of my life will be a fluid solution and will change constantly. There is no such thing as perfect and all I can expect of myself is to do things without regret. Some days I acknowledge this and some days I can’t and that’s okay. What I do know for a fact is that being on both sides of the fence has challenged me to be a better naturopathic doctor and a more empathetic caregiver.
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Dr. Vivian Liang is a naturopathic doctor at Nova Health. She is passionate about the role of naturopathic medicine in integrative cancer care. She is heavily invested in an evidence-based approach to individualized naturopathic care. She has been involved in, co-authored, and presented integrative oncology research throughout her education. She strongly believes in empowering individuals with high-quality evidence to better support their cancer treatment and journey by optimizing quality of life, minimizing side effects from conventional treatments, increase overall survival, and prolong disease-free survival. Dr. Vivian has an open communication policy and believes that as much as she is a doctor, she is also a patient advocate; she strives to improve the individual’s medical experience by communicating with their health care teams.