From professor to patient X.

I walked into the classroom feeling nervous. It wasn't my first time teaching undergraduate students about human endocrine physiology. I knew the material well. But today's lecture was different. I pulled up slides depicting a hypothetical cancer patient and told them, “Patient X had a biopsy that detected invasive carcinoma in her breast.” I described the many months of chemotherapy, surgery, and radiation treatments she went through before going into remission. Then I taught the students about the hormonal therapy she was prescribed—drugs her doctor hoped would limit the growth of any remaining cancer cells and prevent a recurrence. On the final slide, I showed them a picture of me on my last day of chemotherapy. “I am patient X,” I revealed. > “I wanted my students to see me as a person first and a professor second.” When I started my faculty position, I never would have dreamed of giving a lecture that delved into my personal medical history. I made a point of presenting myself as a consummate professional to my students and colleagues. I was only 28 years old—fresh out of my Ph.D. program—and I wanted to be respected as a professor. But that all changed in the second year of my faculty position, when I was diagnosed with an aggressive form of breast cancer. I continued to work while I underwent treatment, which meant that signs of my chemotherapy, such as hair loss, were clearly visible. I told undergraduate students in my classes about my condition, in part to cut short curious stares but also to warn them that my treatment could interfere with my teaching. I appreciated the compassion and care those students showed me—putting together care packages, leaving cards, praying for my recovery. I was taken aback by their maturity and empathy—and reminded that they are people, too. They may have a mother or grandmother who suffered from breast cancer. They may have religious beliefs that call them to pray. When my hair grew back, I didn't want to return to being the same professor I was before. I wanted my students to see me as a person first and a professor second, and I hoped my story would show them that the science they were learning had relevance in the real world. So 1 year after my diagnosis, I developed my lecture about patient X. For nearly 5 years, I gave that lecture, with the positive news that I was in remission: “The power of medicine!” I'd tell them. The nerves never went away—I found it emotionally trying to talk about my body and my disease—but I persisted because the lecture was clearly making an impact. Each time, a few students would stay after class or send me an email, making it clear they appreciated my honesty. Then, in March 2020—just as most people's lives were upended by the COVID-19 pandemic—I got a call from my oncologist. My cancer was back, and it had spread. I was now facing a diagnosis of stage 4 metastatic disease. It was hard news to hear, but I decided to continue my teaching, research, and service activities because I felt the same physically as I did before. I also thought my work would be a welcome distraction from the stress of doctor's visits, tests, and scans. It was time to update patient X's story. At first, I added details about new lines of hormonal treatment and an unfulfilling ending of “time will tell.” More recently, I added somewhat more optimistic news: Patient X's third-line treatment of infusion chemotherapy seems to be working a bit. The metastatic nodules in her lungs have decreased in size and number, and she might have access to new treatment options in the future. My diagnosis has likely shortened the number of years I will have to build and leave a legacy as a scientist, mentor, and teacher. Yet, it has also given me a powerful tool. It helps me connect with my students on a personal level, tap into their empathy, and show them why the material they're learning matters. It isn't easy to be vulnerable with my students. But I believe my personal story is one of the most important lessons I teach all semester.