A psychiatrist being tested by cancer

On Thanksgiving Day in 2010 there were a lot of things that Dr. Randy Hillard could give thanks for. The 61 year old psychiatrist had a loving wife, contented children in adulthood, and his work at Michigan University which he fondly went to everyday day. His health too was in a rather a good state.

Almost…

He felt out of breath going up the stairs and dizzy when he got up from his seat. He consulted a specialist in internal medicine. The specialist requested certain tests in order to establish the cause of his symptoms.

On 1 December 2010 Dr. Hillard read the pathology report in his medical file: “intermediate differentiated ulcerated gastric adenocarcinoma”. On 5 January 2011 the large tumour in his stomach was removed by surgery and it was established that the tumour was a grade 4 tumour. Then Dr. Hillard had to undergo many months of chemotherapy and radiotherapy which are accompanied by severe nausea.

Dr. Hillard recently shared his thoughts and feelings on his struggle with Psychiatric News:

What were your thoughts and feelings when you found out you had grade 4 gastric cancer?

Initially it was more my thoughts than my feelings that had the upper hand. I thought “I am now a dead person. My death will be ugly and painful and nothing in my life has any meaning”. I remembered the frightening side effects produced by chemotherapy in others and the death process of abdominal cancer. I referred to the data base of the National Cancer Institute, which is called SEER, in order to find out about the prognosis (prediction on the course of the illness). The probability of my staying alive for a further 3 years was 30%, and for a further 5 years it was 10%. I considered settling down in Oregon and making use of the doctor aided euthanasia law that this state had. I even contacted the euthanasia organization called Dignitatis in Switzerland.

Did being a psychiatrist have an effect on your reaction to finding out you had cancer?

Due to my psychiatric training I thought that all that I was going through was a short-term fit of insanity or an acute stress reaction with complex emotional characteristics. I noticed that I was not in touch with my feelings, that I was neglecting my feelings. I started going to psychotherapy sessions. I released my feelings so that I could reach out to my wife, children and colleagues.

Did being a psychiatrist help in coping with the severe side effects of chemotherapy and radiotherapy and the fear of not knowing whether you will live or die?

I could say that being a psychiatrist and undergoing psychotherapy helped me to access the fear and despair that lies behind the feelings of shock and horror.

What is your prognosis under present circumstances?

I still have no complaints, and no longer any symptoms of the disease. My doctors said that all is going well, and that in fact they regard me as being in a “cancer-free period” at the moment. Of course they are careful with the words they use, just like we do as psychiatrists when we talk to psychiatric patients. I could refer to the SEER data base again and have a look at the probabilities my living a further one, three or five years, but I do not feel the need to do this. I have passed through all the stages of grief described by Kübler-Ross: denial, anger, bargaining, depression, acceptance (actually, it did not exactly happen in that order). At the moment I am to a large extent back in the denial stage. Recently I bought car, not a second-hand car but a new car, because I think I will last longer than the second-hand car.

Are you working at the moment, and if yes, to what extent?

I actually returned to work in September. I work with mental health students two days a week. I give some lessons, provide supervision and also work on a few interesting research projects. One of these is a trial on the application of new guidelines for the diagnosis of helicobacter infections in people who have relatives with first and second grade gastric cancer (like mine). In one of the hospitals I will help to start up a new specialised branch in the medicine program. I am also committed to giving consultations two days a week in a centre for the care of patients who are in the final stages of cancer.

What are the two most important lessons you learned during your fight against cancer?

I learned that turning productivity into a religion and turning ourselves into robots who only focus on their careers, is really not a good idea. What is really important is relationships and kindness.

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