It's Just Too Much

by Sarah E. McDonald

Geoff and Sarah McDonald
Watch Sarah read this excerpt from her book

Dr. BreastOnc called me three days later to ask if Geoff and I were available to meet with her. She said she had some things she wanted to discuss with us prior to beginning treatments.

We met Dr. BreastOnc in the same room we had met with the team of doctors to discuss my diagnosis and potential treatment plan. I was perched on the examining table again and Geoff was to my right in one of the two metal chairs in the room. Just as she had the first day, Dr. BreastOnc walked into the room, walked up to me, and immediately started rubbing my legs. 

In order to rub my legs, Dr. BreastOnc stood in my personal space – but it wasn’t off-putting. She radiated kindness. She had shoulder length light brown hair that was tied back into a low ponytail. Her voice was soft but firm with a slight accent revealing her New Jersey roots. Her blue eyes looked at me so intensely that I felt she was seeing into my most private thoughts – like she might have an inkling of how much I had been suffering.  

“You’ve both had a lot to process over the last couple of weeks. How are you doing?” she asked gently. 

Given the “treatable” and “curable” news from our last couple of appointments, Geoff and I were feeling reasonably upbeat and optimistic and we said as much to Dr. BreastOnc.

“Listen, I read in your charts that you were pursuing fertility treatments at Stanford when you were first diagnosed with the ACC. Is that right?”

“Yes,” I told her. We’d been meeting with Dr. Fertility for the last two years, had made the tough decision to find an egg donor, and were planning on an IVF cycle at the end of January. I told her we had canceled that due to the ACC diagnosis, but that we now had 16 viable embryos sitting on ice.

“What have you heard about your fertility options at this point?” she asked.

I told her that our fertility doctor was the first person I spoke to about my ACC cancer diagnosis after Geoff. Dr. Fertility had thought that perhaps in two years, after my cancer treatments were finished, we could schedule an IVF and try again to get pregnant.

Dr. BreastOnc looked me directly in the eyes and shook her head at me. 

“I believe your breast cancer diagnosis will impact that plan. Once your breast cancer treatment is completed, I will prescribe a drug for you called tamoxifen that blocks estrogen, which is critical in pregnancies. I will want you to take that drug for the next ten years to prevent a recurrence of your breast cancer, which means we wouldn’t want you to be pregnant for the next ten years. Ten years from now you’ll be 55, and I don’t believe you will be eligible for IVF treatments. You won’t be able to carry a baby.”

I just kept looking at Dr. BreastOnc and blinking as I processed what she was saying. “Oh,” I said and immediately began berating myself silently for having gotten my hopes up. I had two cancer diagnoses. I should feel lucky that they were treatable and that I could reasonably hope to be alive by the end of the year. Who was I to wish for a child?  

I looked at Geoff sitting next to me and could see tears welling up in his eyes. “It’s just too much,” he said softly, his voice shaky with emotion. 

Dr. BreastOnc apologized for having to be the one to deliver this tough news. She spoke about there being many different ways to create a family, and that perhaps after we had had time to process all of this information, we could consider those other options. Then she offered to leave the room and give us some privacy.

That day it felt like cancer had killed all of our dreams.