A difficult diagnosis: Psychiatrist with cancer shares his coping strategies
First of all, being a psychiatrist himself hasn’t been that helpful with his diagnosis.
“I’m a human being first, and I experience emotions after a life-altering diagnosis just like anybody else,” Adam Stern, MD, explains. “Often, I know what I would tell a patient, how I would direct them to deal with certain feelings or thoughts or emotions, and yet I still have trouble doing that myself, in any kind of effective way.”
Stern is an assistant professor of psychiatry at Harvard Medical School. He graduated from Upstate Medical University in 2010. He was diagnosed with kidney cancer in January 2018, when he was 33, and has written extensively about his experience, in medical journals and newspapers.
“Sometimes I feel totally at peace with the diagnosis, and other times I am overwhelmed with sadness, fear or anger,” he writes on a blog. “There are three activities that seem most helpful for me personally: spending time with my wife and 1-year-old son, going for walks with music in my ears, and writing.
Stern had his kidney removed soon after his diagnosis. Almost a year later, he had tumors related to his kidney cancer removed from his lungs. In the year since his diagnosis, he writes in The New York Times, “I’ve lived more fully than ever before in my life, holding my wife and son tighter.”
(Click here to hear Stern talk about how he copes with kidney cancer in a "HealthLink on Air" interview. Click here to see a 2011 video from Stern's medical student days at Upstate, where he talks about his writing for Upstate's "The Healing Muse" literary journal.)
Stern does not recommend Googling disease survival curves — the statistical graphs showing the percentage of people who survive over time. Even so, as many people do after a diagnosis, he immediately searched for his survival odds: a 53 percent chance he would still be alive in five years. He wrote an essay about that.
“In the case of surviving cancer, the path can be construed as binary: to die or not, or it can remain forever in the realm of living with a chronic illness with the threat of death lurking all the time.” Stern continues, “This is hard to accept. Human beings are complex, discerning creatures, but we’re just not built to live contentedly with the uncertainties of an unclear prognosis.”
Survival curves can be depressing, if you see yourself in the middle. Or, you can see yourself on the tail end of the curve and imagine a long life, he says. “It’s much more healthy to do the latter.”
Stern says it’s human nature that people want to hear only positives regarding his prognosis.
“Society as a whole would do well to move toward a more accepting place with regard to death and dying.” He says a good place to start is with the book written by a Harvard colleague, Atul Gawande, MD: “Being Mortal: What Matters in the End.”
Staying busy with his work or engrossed in recreational activities with his family quells Stern’s anxiety about the future.
Some moments even allow him to forget his cancer. “I’m actually able to be mindful of what I’m doing and be in the moment with those activities,” he explains. “Those are the best moments of my day.
“What I do with the rest of the day — which can sometimes be overwhelmed with fear and anxiety — is a challenge. That’s where psychotherapy comes in.”
Stern’s therapist offers “a place where I can bring in those things. It doesn’t help me escape from fears or anxiety, but rather it’s a place where I find acceptance in those thoughts and fears, and a place where I discover ways of coping.”
Children in his life also provide acceptance.
His toddler son and 4- to 7-year-old nieces and nephews are the only people within Stern’s orbit who don’t know he’s sick. “They are really such a gift to me,” he says.
“It’s such an amazing opportunity to interact with someone where the interaction is completely genuine from their end. They have no idea what’s going on in terms of my illness. So for my son, I’m just Dad — and that’s a real pleasure.”
Before his diagnosis, Stern was a “people pleaser” who agreed to almost any task that was asked of him. “I now only say yes to things that actually will align with this vision of who I want to be and how I want to spend the time that I have.
That applies across the board to all aspects of my life,” he says.
“I’ve learned to live every day as well as I can, with as much meaning and purpose as I can. And I don’t think people should wait until they are diagnosed with cancer or another life-threatening condition before they start to live their lives this way.”
He took up the practice of actively pursuing gratitude.
At the end of each day, Stern thinks back on what went well, what he appreciated. He keeps a journal.
“That’s a way you can actually feel better about how your life is going and appreciate the things that are going well in your life, even when things are tough.”
Doodling helped him process his feelings.
They were just simple drawings, kind of like Gary Larson’s “The Far Side,” that poked fun at doctors or therapists. Stern soon realized he had a collection of cartoons.So, he produced a cartoon book called “Shrunk, MD,” that sells for $12.99 on amazon.com. Book sales so far have raised more than $6,000 for KC Cure, an organization that pays for kidney cancer research.
“If you’re on the fence about pursuing some random dream of yours, just go for it,” he advises. Stern had been unsure about whether to put forth the effort for a cartoon book, “but it’s something I’m so happy that I did.
“The worst case scenario is that it doesn’t work out. The best case scenario is that you do something that you’re happy with, that you can remember and be proud of.”
12 ways Dr. Stern copes with kidney cancer
These are things that have helped Stern, but he points out that we all cope in different ways. What’s important is to find what works for you, he says.
- Family time
- Walks with music
- Imagining a long life
- Being mindful in the moment
- Hanging out with children in his family who don’t know he’s sick
- Rethinking his time
- Gratitude journal
- Pursuing a lofty dream
- Accepting that death is part of life
This article appears in the summer 2019 issue of Cancer Care magazine.