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By Way of Introduction
Hello! I am Joseph and this is my blog – exciting, isn’t it? I'm a Junior Doctor in North Central London. The truth is, this blog was started by me in December 2013 and originally featured on my Wordpress profile (http://josephmachta.wordpress.com) - please pardon any anachronisms! The blog revolves around my diagnosis and treatment of cancer and how it affects my life and medical practise today.
I by no means intend this to be a fully exhaustive window into the experiences of all cancer patients/survivors – on the contrary, these will be very much my own points of view and I doubt many will share them. Most importantly, it’s all real, it’s all true, and it all happened to me – so I thank you for reading and hope you enjoy!
Ten Years Ago Today
Ten years ago today, I landed in Australia for my uncle’s wedding. I was an overweight, shy, unconfident teenager with a penchant for rock music and pain-au-chocolat. I had been feeling generally unwell for some weeks prior to my arrival – having had weight loss, recurrent infections and excruciating bone pain, amongst other symptoms, all of which my doctor in London had erroneously but understandably explained in terms of growing pains and viral myalgia (muscular pain caused by a virus) and had prescribed me a large and continuing dose of anti-inflammatory medications, which didn’t really help.
So as not to waste your attention so early in the blog, I won’t go into the finer details of how it came to this at this point, but on the 18th December 2003 I was admitted to Sydney Children’s Hospital (SCH) with gastric ulcers and deranged blood results indicating kidney failure. The ulcers were a result of my habitual Ibuprofen use (which I would now always warn against, especially on an empty stomach) and my kidney failure was a result of what I’d soon find out was my underlying cancer diagnosis. Two days later, after numerous investigations, I found myself waking up in the unfamiliar environs of the SCH Intensive Care Unit. With an intense new ache in my lower back (from a bone marrow biopsy and trephine – where they stick a needle into your pelvis at the back, suck out some bone marrow and chip off some bone for tests) and tubes sticking out of my wrists and neck. My mother, tears welling up, approached the end of my bed with one of the nurses and broke the news…
“Joseph” she said, “they’ve done some tests and they’ve found out that… You’ve got cancer.”
That was it. Very clear, very simple and succinct, three words: “You. Have. Cancer.” That was the moment and those were the three words that changed my adolescence and my approach to life, forever. Those three words woke me up from what then seemed to be a 15 year sleep. Those three words, with all of their sinister connotations, induced the greatest fear imaginable whilst paradoxically, however, affording me unprecedented feelings of confidence, strength and empowerment.
I was given the diagnosis of ALL – Acute Lymphoblastic Leukaemia. I was told that I’d have a course of chemo treatment spanning two years, which would be easily managed alongside school and my normal activities. However, a few hours later after further testing, it emerged that in fact I had a different type of cancer – Burkitt Lymphoma/Leukaemia, Stage 4 (there are only four stages). The cancer had infiltrated my kidneys and caused them to fail, my bone marrow was 97% leukaemic and so as you can imagine I was feeling a little worse for wear.
A little side note on Burkitt Lymphoma: It is defined in the Oxford Medical dictionary as the “most aggressive of all malignancies… Cure is uncommon” and accounts for a mere 1% of all Non-Hodgkins Lymphomas (the more common type of lymphoma). There are two types of Burkitt Lymphoma: endemic and sporadic. Endemic is seen mainly in West Africa in children with mosquito-transmitted Epstein-Barr virus (the virus behind Infectious Mononucleosis aka. Glandular Fever) and often presents with jaw tumours. Sporadic – the type seen in the developed world – is most commonly associated with a specific chromosomal (genetic) abnormality called an 8:14 translocation. The other significant thing about Burkitt Lymphoma is that because of its aggressive nature, its management must be equally as aggressive. This meant that instead of two years of manageable treatment, I was to have about 9 months of extremely aggressive, high dose chemo, which began at Sydney Children’s Hospital shortly after I was diagnosed.
Now, a decade later and almost a qualified doctor, I am returning to Sydney Children’s Hospital to work on a practice placement at C2-West – the ward on which I was diagnosed and treated, with the medical team who saved my life. Today I went back for the first time in a few years and simply walking through the entrance gave me shivers. For me, SCH represents many different things. On the one hand, it’s a place of great physical and emotional pain, suffering and fear – my own hell on earth. On the other hand, it represents a time when my life changed forever for the good, a place I discovered my confidence and the home of one of the greatest achievements of my life so far. It represents for me both tragedy and triumph all at once. Being there today, attending a ward round on my old ward and seeing patients in my old bed spaces, being treated by my old doctors and nurses has been surreal and incredibly exciting.
On the 18th December 2003 – ten years ago today – I began a journey that would teach me some incredibly valuable and unique lessons of which I’m still reminded to this day and which still shape my approach to relationships, medicine and life itself. Today, 18th December 2013, I got the chance to implement those lessons where it all began – and no experience in my medical school life so far has been so meaningful.