A Doctor’s Story of Reconnecting to His Humanity

Good morning. I’m Tony. I’m a surgeon. I’m an ear, nose and throat surgeon. And back in medical school, I had really good teachers. And they taught me that the most valuable tool I had in my toolbox was empathy, right? Feel what they’re feeling so that you can better guide them through the most difficult parts of their lives with emotional intelligence. And I was really good at empathy. It came really naturally to me. Um, so naturally, in fact, that I made a promise to myself really early on to never ever become numb to the pain that I was tasked to heal.

And then, I saw death. Again and again and again in all of its forms. Just sudden and tragic, slow, painful, and tragic, expected, quiet, and tragic, bloody, violent, and tragic. And the more I saw of it, the less tragic it became. I mean, sure, the families were still wailing in agony or yelling in rage and instead of feeling it right along with them, at some point, I just stopped. And I think it’s because death started to look different to me. It lost its mystique. It was no longer some boogeyman in the wings. It was actually really simple: lungs stop breathing, heart stops beating, blood vessels stop bringing oxygen to the organs, and without oxygen, the organs suffocate. So death was nothing more than a series of mechanical failures. And how do you mourn a failed machine? You don’t. So I didn’t. I didn’t grieve, I didn’t mourn, I didn’t cry due to death for five years. And by the end of my training, I was pretty sure there was something wrong with me, uh, because I could no longer connect to people when they needed me the most. And I had this sinking feeling that that ability just wasn’t coming back, that I was going to be that much more disconnected and that much more lonely all the time, every day, for the rest of my life. The perks of saving lives, right?

Which brings me to my friend, Zach. Now, Zach is one of those great friends, really special friends, where we didn’t grow up together as kids. I met him in college, but we grew up together once we became adults. And if you have those friends, they’re, they’re really special. And Zach was loud and boisterous and just this force of nature. Like if Zach called you, you picked up the phone. And so I didn’t even think about it when Zach called me one day and said, “Hey, come over to my house. I just want you to look at something.” So Zach had had a lump on the roof of his mouth for a few weeks. So he went to the dentist, they did a CT scan, and Zach brought the scan home for me to take a look at. And lumps and bumps of the head and neck, they’re my specialty. So I scrolled through the scan, and I was sure about what I was seeing: an aggressive cancerous tumor. And it wasn’t great. And I told Zach as much. And he said, “Okay, what’s the worst-case scenario?” And I told him, “Uh, massive disfiguring surgery, chemotherapy, radiation, your life is going to drastically change.” And Zach didn’t panic, he didn’t cry. He said, “Okay, guess it’s time to fight.” And he made me promise one thing as his doctor friend: always tell him the truth, never sugarcoat anything.

And I was able to honor that promise for all of 48 hours when he sent me his diagnosis: adenoid cystic carcinoma of a minor salivary gland. Now, again, this is my specialty. So this is a cancer I know like an old friend. And this old friend is very stubborn. You can cut it out, you can fry it with radiation, you can poison it with chemotherapy, you can eradicate every detectable trace of this cancer, and still, a handful of cells would hide on a nerve somewhere, like they were in a World War II bunker, just waiting for the treatment to finish so that they could grow again. And when it grew again, it was that much harder to treat. So I knew the numbers. With this type of cancer, in this location, at this stage, the most likely prognosis for Zach was that he would be dead within five years. And I couldn’t tell him. I couldn’t be the one to take hope away from him. And if he was going to be one of those rare few that made it through, hope is what he was going to need. So I decided I was going to make it up to him by just being there for him throughout his entire treatment, whatever he needed.

And the treatment was rough. It started with the casual brutality we call life-saving surgery. Um, we removed—oh, I didn’t remove, but they removed—uh, half of his upper mouth and replaced it with a really fancy dental prosthetic with teeth. So he had to learn to chew and swallow again. And then the radiation fried his throat tissue, so every time he swallowed, it burned terribly for months. And then chemotherapy just made him feel sick, made him feel weak. But he said he was going to fight, and he fought. He didn’t just fight against the pain and the physical changes, he fought for his humanity. He fought to stay who he’d always been. And he adopted a puppy and raised it with his husband. He taught himself to sing again through false teeth. We actually, even when, uh, you know, he was doing really well after his treatment, we planned a trip. We’re going to go to the Essence Festival in New Orleans and just celebrate how far he’d come. So hope was doing its work.

And then Zach called. So, of course, I answered. And something was wrong. He’d been having pain in his back for a few days, and he woke up that morning, and he couldn’t move his leg. So the cancer had made its way to his spine, and he needed emergency surgery to give him a chance at ever walking again. So we repurposed our boys’ trip, and instead of partying in New Orleans, we had a much more subdued party in his hospital room in Houston.

Now, this trip, this trip was, was, it was heavy, because the cancer hadn’t just come back, it had metastasized. Remember, it started in his mouth, now it was on his spinal cord. And the odds were it was eventually going to make its way to his lungs. So this wasn’t just some setback. Death was coming, and I was at the end of my medical expertise. And it left me feeling exposed because he didn’t need a doctor anymore. He needed his friend. He needed empathy. He needed all those emotions that I had lost at some point along the way and no longer had access to. So on that flight down to Houston, I had two questions bouncing through my head the entire time: What do I have left to give my friend that would have any meaning? And what does it mean for me if I no longer have the capacity to feel grief this close to my heart?

So after a couple of nights, uh, I was alone with Zach in his hospital room, and it’s really late, and we’ve been talking and talking. And then it suddenly dawned on me, the question that my brutal training and my, you know, diminished humanity left me uniquely equipped to ask: “Do you want to talk about death?” And I knew he, you know, he couldn’t with his loved ones, his husband, his mother. Like, there was, the air was thick with prayer and hope and talk of miracles and all of that great aspirational stuff. But death was in the room, and I could feel it, and I had a feeling that he could feel it, too. And he said, “Yeah, I really do.” And so we did. You know, we talked about the mechanics, we talked about the shape that death might take for him, how it might feel. We talked about faith and how sometimes it brought him comfort, but a lot of the time, it just left him wanting. And we talked about the burdens that he was ready to lay down. He’d been a father figure to his siblings and his cousins for his entire life, and now, here at the end, all he wanted was someone to take care of him and to love him and to hold him and just tell him things were going to be okay. And the words just flowed out of him. It was like an avalanche. And I think that freedom to speak about it was because finally, nobody in that room feared death. Death was just the next step. It was just the next part of life.

So Zach died a few months later, just like I thought. Cancer went to his lungs, just another series of mechanical failures. And when I heard the news, I was sad, but I didn’t feel it in my bones. And that disconnect felt disrespectful to his memory. And it also seemed to confirm that I had become something less than human. And so, in the church for his funeral, I realized that was maybe partially true. I had changed, but I wasn’t broken. You know, empathy hadn’t just left. It was a choice that I had made to protect myself. And so it would stand to reason that I could also choose to bring it back. You know, death—uh, not death, but grief—it wasn’t just going to find me anymore. That much had changed. But I could go get it. I could invite it but I had to be intentional so I let it in. I let in the sight of Zach embalmed in his coffin. I let in the sound of all the voices that were just agonized, bouncing off the walls of the church. I let in the feeling of my hand on my friend’s back as he just quaked, as he wept. I just let it all in and just sank under it and then thankfully, I cried so hard for the first time in years and years and years.

So, what would I like you to take away from this story? Well I know many of us in this room deal with death professionally and that changes your relationship with death it can change your relationship with yourself and it can feel like you’ve lost something. But, I want to tell you you are not broken. You actually have gained a gift and the gift is this choice that you now have. You can now choose to bring death into the conversations. You can bring it into rooms with you and it’s so meaningful for the dying because they want to talk about it and you can also choose to feel grief and anger. You can choose to feel your sadness and let it ground you in your humanity. We are not broken. We’ve been given this gift of this choice and we are so much better for it. Thank you.