How it went =========== * Denise Koh The picture’s somewhat fuzzy now, but I remember your bright kitchen — the sunny room juxtaposing this ugly thing killing you from the inside. You shyly remove your scarf to reveal the “do.” There’s this imperceptible moment where I process the enormity of what I’m seeing but instinctively, push out that we-are-invincible, Pat Benatar vibe we’d reserve for our nights out on the town. “I love it! You look go-o-od. Seriously sexy! You’ve got this perfectly shaped head. I could never pull that off with my weird bumpy head, and you look fierce, badass!” I do a quick affirming undulation, grooving to some soundtrack, signalling that you’re oozing sexy glam. You tell me your hubby says you’re beautiful in this look, and I echo this because it’s true. You’re incredibly beautiful — not the magazine, symmetrical type of beauty, but the rare kind that only comes with love and courage, struggle and fragility, pain and grit. I notice how your baggy clothes hang on your bony frame, the thinness of your wrist, and quickly shake those images away. *We are warriors now. We will fight this. We will win*.1 Without even realizing it, we systematically go over your issue list and management plan, as only doctors would do. Treatments, prognosis, your meds and their side effects. The nausea, sleep issues, pain, meal prep, juicing, other options. I push from the mindfulness angle, citing examples of miracle cures from my reading, my own incredible achievements as a patient in mind–body work. I propose a plan of attack. We quickly tiptoe through the discussion of how J is handling all of this, what would happen to him in different scenarios. Single and pregnant with my first, I don’t have a lot of advice about this biggest, most painful pull on your heart. Neither of us have the right answers for this. You joke about rocking your new skinny bod. I throw in something about how I looked my size zero “best” during my darkest days, and we laugh at this idiotic choice of beauty over health. Yes, we are doctors, but first, we are girls, shaped by this twisted society to always want our looks, can’t help but want them, even if it’s only a theoretical want now. At least the messed up black humour of cynical docs deep in the trenches is still alive, here. And I’m relieved that you’re still you, we’re still ok, we will get past this. You walk me through a smudging; you show me your jingle dress, eagle feather, your beautiful beaded regalia. We even talk about where these would go after you died (I realize now how, even then, you were still the martyr. You said everything to save me, pulled all those punches and turned them onto yourself.) Damn you for not telling me the diagnosis until so late; you didn’t want me stressing during my IVF process. Hate and love you for that —or is it love then hate? “I miss my life,” you say in a small voice. I still hear it, after so many years. For the life of me I can’t remember if we cried together or if I piled on that toxic positivity because I couldn’t, still now can’t, fully deal. The memory just stops with those words. \* * *| I’m Mother Hen on this packed dance floor in Puerto Vallarta, scanning the crowd to locate you and the others from our posse. I’ve accepted this role. We have too much to lose in our real lives to abandon logic and structure, go off the deep end, do our tame version of Girls Gone Wild, Mexico edition, even though, God knows, we freaking deserve to party. I see you, *Blue Star Woman*. You’re going against the grain. Your eyes are closed. You seem transported, trance-like. It’s pure ecstasy on your face, but your dance is different. Head down, arm up, strong — almost severe — full-body swoops and stomps, a powerful masculine energy. Definitely not the seductive pelvic sways the rest of us gals use for top-40 beats in nightclubs, the moves that whisper: *Choose me. I’m ready to mate*. No, you don’t even register anyone else; it’s only you. You’re lost, moving to this steady beating drum. Your heartbeat, it’s all you hear. I picture you at a pow wow, performing this ceremonial dance, connecting you to the earth, a celebration of life. *Wicankpe To Win* — It’d be years before I’d learn your Indigenous name from the obituary, years before I’d get the full picture of you, understand the star blankets, the settings, the Flower Days, witness every single community member line up to shake my hand at your funeral. \* * *| You’re now in hospital, just admitted with respiratory distress. Which chemo drug was it again that triggered your fibrosis? Strange–funny how we take ownership of disease, like it’s the same as “your sweater” or “your car,” but as you know, it’s not. I’m standing at the foot of your bed. You’re scared but putting on a brave front (I realize now, stupidly, that what you were doing was for me more than for you). I have to take my baby to my parents’ place in Regina; I’m not sure when I’ll be back. I’m a mess, as all new moms generally are, a million things swirling in my head — the to-dos, what ifs, hang-ups associated with suddenly being responsible for this whole other life — me not on top of any of them. You don’t think you’ll be discharged; you’ll die here. Your breaths get more shallow as you try to get your words out. I’m certain we need to double-down, here. In my mind, I consider all my reading: mind–body connection, healing, manifestation, my own string of successes from this work as a patient, despite overwhelming odds. The biggest proof: my beautiful, impossible baby. *Nope, nope, nope. Stop. We’re not talking defeatist. It starts with mindset. We ARE fighting this. We ARE winning. Let me show you. Fight to the end*. Thelma clasps Louise’s hand in that power grip before they drive off the cliff. \* * *| You’re in ICU. It all happened so fast; it’s surreal. None of it makes sense. I wrote a healing script I’d read to you even though you couldn’t react much. I put it in your tray table drawer so anyone could read to you. I don’t know where it went, but it was long, comprehensive; I poured everything I had into it. My dad is watching the baby in the waiting room so I can visit. I take shifts with the rest of your huge family to see you, hold your hand. The decision is made to take you off life support, and I can’t tell you how enraged I am — it’s shock-rage, really. I frantically rack my brain. *Who do I talk to, to reverse this*? *What doctor levers do I need to pull here*? But I’m not on the next-of-kin list; it’s a done deal. And now we’re all filing into your “room;” I never counted how many of us there were. We packed in there around you, hoping you’d sense our love and presence. I’m sitting on the bed, stretched across your legs to reach, touch your hand. We’re all crying, sobbing, but I’m not giving up. *I’m the doctor, I have to fight*. I’m pushing all my healing vibes into you, anything I’ve ever learned or picked up in this crazy hellish ride through Medicine. Someone comes in and disconnects the trach. I’m staring at the monitor, willing you to breathe. *Come on, T, breathe. Please. Come on. You can do it. We’ve got this. We can do anything*. I watch you make an effort to inhale, but it just stops. There’s no movement there. My mind is pleading, shouting at you to breathe. *Come on, dammit, breathe. Do it. Fucking breathe. Just a breath. Something. Anything. Show those assholes they’re wrong. BREATHE*! We’re stuck at this spot; you’re weakly pushing against this immovable barrier and I can see how you won’t be able to push past it. I see your fight weaken; the monitors start to respond. I’m reviewing all the pieces of information I know about your medical status, and now they’re adding up to a “no” instead of a “yes.” How did I miss that? I feel sick, panicky. I’m still begging, screaming at you in my head. It’s so loud now. *Don’t leave me. Don’t leave me! PLEASE! I love you. I need you*! And then you’re gone. That’s it. I don’t — that’s how it went. ## Footnotes * The family of the patient depicted here gave written consent for her story to be told. * This article has been peer reviewed. * Author’s note: The use of war metaphors (e.g., “fight,” “plan of attack,” “warrior,” “win/lose”) in oncology has been shown to be both empowering and disempowering to patients and physicians, and McEachern urges discussion about this dichotomy rather than removal of these terms.1 Accordingly, these terms have been intentionally included in this article to reflect actual dialogue, the common thinking and practice at the time, and empowering imagery commonly used in hypnotherapeutic practice. This dichotomy in metaphor effects also highlights the complexities of the circumstances and changing relationship between close physician friends, one whose role becomes a patient protecting her friend, while the other becomes a healer trying desperately to prolong her friend’s life. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: [https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/) ## Reference 1. McEachern RW. We need to talk about war metaphors in oncology. JCO Oncol Pract 2022;18:601–2.