The Worst

I thought the worst was over. Surgery, chemo, hormonal treatment, which they don’t tell you is actually hormone-blocking treatment. So then: hot flashes, crappy sleep, looking for clothes that disguise my lopsided chest.

But I’m still here, mostly, and without the cancer. My husband is still here, too, a good guy who came with me to all the chemo infusions, though I’m not sure he gets it. I come back from my first time to the pool for lap-swimming, tell him it was hard getting into my bathing suit and walking out onto the pool deck. “It’s OK,” he says, “I’m sure no one was checking you out.”

Then my oncologist disappears. Fired, apparently.


After my last appointment with him back in early November, when everything seemed OK, at least on his end, I walked past the window where I was supposed to schedule my next appointment. I was in a rush to get to work. Also I had a flare of superstition about scheduling anything, even three months out. It was a year since my diagnosis, less than six months since the end of chemo.

When I make myself call for the appointment a few weeks later, the scheduler tells me my oncologist is on leave and she isn’t sure when he’ll be back. Two weeks after that I get a letter from the hospital. Departing our organization after many years of valuable service….you will of course continue to receive the excellent care you are accustomed to from our world-class Cancer Center….blah, blah, blah.

When I met my oncologist for the first time, he looked into my eyes as he shook my hand with his warm, dry hand. He wasn’t much taller than me. Little round glasses, quick brown eyes, a very dry sense of humor. We had an affinity. Toward the end of the meeting, I asked him how often I would be seeing him. “Enough to get sick of me,” he said.


After the letter, no more information. I wonder more and more about the real story. So I ask my friend who is a pharmacist at the hospital. She saw him earlier the same week he disappeared. He looked the same as usual Tuesday, gone on Thursday. She heard they locked his office and he wasn’t allowed back in. She says the rumor is he made inappropriate advances at one of the nurses.

“That doesn’t sound like him,” I say.  “I know,” she says, “but getting fired doesn’t sound like him, either.”

Meanwhile the season darkens. I make it through the holidays. My daughter buzzes from one activity to another, gets her college applications done with only a minor meltdown or two. She has seemed remarkably OK during all this.

When I mention how I don’t want to think about last winter, my husband says, “Why, what happened last winter?”

I give him a look.

“Cancer? The time they lopped off my breast?”

“Oh, sorry,” he says. “Of course. I thought you meant something that happened in the world.”


I find a new oncologist. Tall. White hair, blue eyes, long fingers. Aristocratic demeanor.  “Have you noticed anything unusual here?” he asks, doing light and rapid arpeggios on the flat, dented side of my chest. I’m still mid-shake of my head when he withdraws his hand, says, “Me neither.”

I graduate from every-three-month appointments to every six months.


On a sunny, warmish day in late March, I go running at the lake. I’m doing a jog-walk, still trying to get my strength back, looking around at the tiny new leaves on all the trees, not thinking about cancer at all. And there’s my oncologist holding hands with his wife, walking around the lake in the opposite direction from me. I’m in a jogging stretch as I approach them. Jouncing along (asymmetrically, remember), I recognize him. Deduce the petite woman holding his hand must be his wife. Make eye contact. Him, briefly her, then him again.

“You’re looking fabulous!” He says to me, beaming. An oncologist must be the only man in the world who can say that to women he passes while out walking with his wife. I beam back at him. I can’t help it, I’m so happy to see him. “Thank you,” I respond, the way you do.

Once past them, I slow to a walk and other emotions catch up with me. I imagine running back the other direction, shouting, “What the hell?”

For the next quarter mile, I am jealous the oncologist and his wife go on walks, holding hands. During the quarter mile after that, I decide that walking around the lake together is an assignment from their couples’ therapist.

I pass them again on the opposite side of the lake, during another jogging stretch, and we smile and nod to each other without saying anything.


When I tell my friend about it, she says she’s heard that my oncologist has a new job at a nearby hospital, so he must not have done anything too terrible. “Not lose-your-license-terrible, anyway.” Maybe he read the electronic chart of a colleague’s girlfriend? Maybe he prescribed diet pills to one of his cancer patients or ADHD meds to his own kid? Maybe he was inappropriate with a nurse in a not so terrible way?

I finally get around to telling my husband that my oncologist left unexpectedly.

“Is he alright?” asks my husband.


Last spring – a year ago now – when we met every few weeks to see how I was faring with chemo, my oncologist and I talked about all the different things that could lower the chances my cancer would stage a second coming. Cutting, poisoning, starving, I thought to myself.  I had a bit of an epiphany. How early on, smacked with the diagnosis, you’re terrified. You don’t know what you’re in for, either from the disease or the treatment. It’s one uncertainty after another. The epiphany was that you find out the brutality of the treatment before you find out whether it works.

“There’s so much we don’t know!” I complained to my oncologist. “But I know I hate chemotherapy. I know I hate estrogen-deprivation.” (I didn’t mention my sacrificed left breast. I didn’t want to remind either of us. Plus that was the surgeon’s doing, not his.)

My oncologist did not disagree with me.

“If you do well, we won’t know why, but we’ll be grateful,” he said.


Summer comes around. I’m still counting the months, tracking the milestones. I’ve survived eighteen months since surgery (the length of two pregnancies). It’s a sweet season, except for extra hot flashes. I decide I’m not so scared anymore. My husband and I go canoeing on the lake a few times; we paddle pretty well together, not talking much. My kid quite happily goes off to college.

In September I run into my old oncologist at the farmer’s market. Not surprising. It’s a small community. He is standing near the flagpole, holding an overflowing tote bag. A loaf of bread and an abundance of produce sprout from the top. He looks like he’s waiting while his wife goes back for one last thing.

I’m eating a chocolate chip cookie and holding a flat of late raspberries. I could pretend not to see him, but it turns out I can’t. I walk closer, wave with my cookie hand.

“How are you?” he asks. His gaze is direct, as ever.

“I’m doing well,” I say, “but….” I would like to say I miss him. Instead I say, “But my husband is worried about you.”

“Doing well is good,” he says. “I don’t want anyone to worry, but if he insists….”

The carrot greens in his bag tremble delicately in the glowing autumn light.  “Tell your husband to worry about someone other than me.”


The following month I make it to the two-year mark. On our second meeting, the new oncologist flips open my file, refers to his notes about me, handwritten, densely-packed, filling up a single sheet of unlined paper.

“Your prognosis is quite good,” he says, sounding a little surprised.

My sleep is still crappy. Although I would tell you otherwise, any unusual twinge provokes a wave of terror and dread. When the new oncologist asks me about anxiety, I say I’m fine. But the tears rise. He plucks out one, two, three tissues, and passes them to me in a practiced motion.

I rub the tissues across my face but wetness keeps rolling downward.

I hear the voice of my old oncologist in the nearly-identical exam room next to this one. That time, I had the tissues wadded up in each hand before he even entered the room. There were three more chemo sessions to go. Everything tasted funny, I couldn’t feel my feet, and when I could feel them they were on fire. My eyebrows were gone. My thighs were skinny, not in a good way.

He opened the door, looked me over carefully.

“Joanie,” he said. “I know it’s hard.”

“I don’t know if I can keep going,” I said, choked, nearly inaudible.

I can hear his low, plain voice even now. “Joanie, we are going to get through this together.”

November 20, 2020

Shala Erlich

Shala Erlich is a practicing psychiatrist in Bellingham, WA. She has published nonfiction in Lilith Magazine, and is working on a novel following a psychiatry resident through a single night shift. This is her first published short story.

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