Dear Doctor McFadden...

I have wanted to write this letter for a long time. Indeed, I wrote a version of it, but I don't remember if I ever passed it to its intended. I think I was too embarrassed at the time.

Well, today I listened to CBC's White Coat, Black Art, and after a few minutes of interviews of comedians about their experiences with illness and the health care system, they suggested we write a letter to a doctor, or a patient (I notice they foolishly left out nurses, etc.) and then send it to, well, to the radio program. Which seems a bit indirect, but let's see where we go with this.

Approaching five years ago I received a cancer diagnosis which at first blush looked very scary and promised a substantial removal of flesh which would not regrow. But if I was lucky, I wouldn't die.

I had heard many good things about the BC Cancer Agency and expected treatment that was excellent, but I was cowed by the vastness of the place, the unfriendliness of some of the staff (no more, I suspect, than in any other large corporation), and the general on-your-own-ness of being there. Worse was the inability to make a human connection with my surgeon. I was hugely relieved when he was taken off the case. (They discuss each case as a group and decide who does what—a wise approach, I think. Far better than being stuck with the first specialist with a slot available and following whatever he or she thinks is best.)

Soon I met Dr. Andy McFadden, and everything began to change. He was emotionally available, funny, kind, as good a surgeon as the last fellow (better for my situation) but far superior in terms of helping me feel at ease. I don't recall if it was he who told me that the tumour was small enough that I had a pretty good chance of not being killed by it, but I do recall that he poohpoohed the previous doctor's ambitious plans for my flesh and said we could get away with a much more conservative excavation. (World tilts back on its original axis, almost.)

After the initial surgery, when he wanted to go back in to improve the margins (to my horror), I nervously agreed (better that than pop off too soon) and he said if I ever had any questions he was always available.

I believe I laughed. At that time, in that office (he works in several, as far as I can tell), there was a young receptionist who was impossible to get past. If I called and left a message, I never received answers. I took to bussing down to the hospital and sitting in the chair in front of her until she was forced to find out what I needed. (I sound awful. But how much more awful to have the whole thing unfold with no communication at all? And of course, I exaggerate. I think I did that once. Maybe twice.)

So when he said he was always available I exclaimed, "Great! Just tell me how to get around your receptionist!" He blushed, and said something about this showing how overworked they are there. (Which I utterly believe.) He then made it possible for me to get directly in touch with him, bypassing her entirely.

Over the duration of our relationship, I used that option exactly twice. He immediately got back to me, said a quick, friendly hello, answered my question, and left me to sail (sort of) onward with much less anxiety.

So this is my letter:

Dear Dr. McFadden. Dear Andy.

I cannot tell you how dear you still are to me, having midwifed me through the worst time of my adult life. I have continued in cancer circles since then and have seen the alternative routes mine could have taken. I have tried to learn courage in all of this, knowing that like you, I can give much more to my friends and contacts when they are facing disease, loss, and death if I can sit through my own fear and hang onto my connection with them as real and living human beings. (That's the key, isn't it? You treat us as living, not as sick.)

I never felt like you viewed me as a "case", though you were diligent and precise in your thought about the cancer. You were always warm, always kept your sense of humour, didn't waste time but never hurried me, either. You asked me about the books I was reading, shared thoughts about important things in our lives that had nothing to do with cancer, and made yourself available to help stave off the terror that was eating away at me more voraciously than the cancer.

Now that I am writing, this seems like all the letters written by all the people who ever were in trouble and received help. I have no grand insight to offer and no amazing way to frame it. It's just deep, enduring gratitude and love for the great humanity you brought along with your awesome skill.

You look very sweet in scrubs, by the way. That helped, too.

Love, and hopes for the very best that life can give you. Oh, and these flowers are for you.

Till we meet again.

Casey

(Watch Andy pitch the Top to Bottom campaign for Colon Cancer Canada.)