No fun having cancer.
Many people have an aversion to posing for a photograph. For years I avoided having my own picture taken in social situations, embarrassed at how unflattering the image always seemed to appear, and maybe in denial at how accurate it actually was. Some of my patients similarly refuse, perhaps because they may feel they aren’t looking their best in our waiting area, preparing for chemotherapy; and perhaps worried that the photo might make their cancer diagnosis that much more concrete. In these cases, the upper left corner of the computer screen contains a white box with the message “Patient Declined Photo.”
I probably would decline too.
When prompted to have their picture taken, some of my patients do manage to summon a smile, though I can’t tell whether it is genuine or “habit being so strong,” as Raymond Carver described the thanks he gave to the doctor who told him he had lung cancer in his poem “What the Doctor Said.” For some of my millennial patients in particular, I am convinced the smile is ironic, reflecting the paradox of expressing joy before a checkup with a cancer doctor.
Patients can also upload their own photos to the electronic medical record, providing a glimpse of what their lives look like outside my clinic. One 21-year-old stares winsomely at me from her bedroom, her dresser and a small picture in the background, from a time that preceded her cancer diagnosis.
If she only knew what was coming.
Another woman in her 40s cheekily uploaded a picture in which she’s flanked by two dogs in her yard, all three facing the camera and grinning ear-to-ear on a beautiful, sunny day. It’s as if she’s thumbing her nose at cancer, using the photo to say that it won’t define who she is. Now that I know she has dogs, they have become a frequent topic of conversation during our visits.
That image brings me joy every time I open her medical record.
The photos are a snapshot in time, capturing a truth that may no longer be accurate: patients bundled up in a scarf and hat when I see them in August, or wearing a tank top in the dead of winter; patients who appear gaunt and bald, their photos taken during the throes of chemotherapy, now greet me in clinic with rounded cheeks and a full head of hair, in remission from their cancer.