Cancer is the word nobody wants to speak. We’d rather discuss anything else—with anyone we can find (did you see the clouds this morning?)—than confront the illogical and arbitrary suffering that cancer brings. Any talk that does exist seems to occur behind closed doors, never crossing the threshold of public life. Yet there are two exceptions for whom it’s a daily topic: either you work in cancer care, or you’re a cancer patient.
Theresa Brown differs from most because she found herself in both circumstances—a unique disposition detailed in her new memoir, Healing: When a Nurse Becomes a Patient. Brown invites her reader on a roving path which oscillates between two timelines: one detailing her former duties and experiences as a oncology and hospice nurse, and the other dissecting the care (or lack thereof) she received as a breast cancer patient.
This structure allows Brown to take us deep into the conflicts born from these contrasting experiences, and it’s from the cold radiology room, mid-biopsy and topless, that she first feels less like a human and more like a body; that she comes to asks herself: did she care about her patients enough? If not, what got in the way of human-to-human care? The latter question spurns Brown’s book-long examination of the American healthcare system, which treats patients like objects in what she calls an “assembly line”—a system worried less about positive care experiences and outcomes, and more about churning patients through procedures that can be billed for profit.
We see this play out first-hand during the author’s breast cancer treatment, which entails a series of delayed test results, plus receptionists who show no urgency in supporting their patient’s care, instead offering disinterested remarks like, “you just missed her” and “you’re not on the list.” There’s also a well-known surgeon, Dr. S., whose quirks included singing Looney Tunes before surgery and passing off mildly aggressive comments as jokes. It’s within such obstacles that the author’s background as a nurse serves most helpful, since she offers insight into why healthcare workers get pushed to the breaking point. According to Brown, of all the challenges nurses face, bullying is a core contributor to burnout, and it isn’t rare for nurses to arrive at work sick, minimizing their own health needs for fear of displaying vulnerability. These working conditions, conflated with long hours and low pay, are what contribute to a growing national disinterest in compassion.
It’s crucial to mention that Brown does always get the answers she needs eventually, either by calling up powerful people in her healthcare network, or her husband, to tug the strings for her. I would’ve been pleasantly surprised to see the perks of being a white, college-educated, upper middle-class woman with access to the inner workings of the healthcare system addressed more explicitly. Especially since Brown delves into the intersectionalities of care, addressing the inequities that arise in America for poor people, Black people, and poor Black people. She notes the mortality rate for Black women with breast cancer to be nearly twice that of white women, yet she fails to make her privilege personal.
In particular, she doesn’t ask: do Black women suffer and die at higher rates from breast cancer because hospitals don’t have bandwidth to save everyone, and they only have ears to hear the demands of rich white women and the men with whom they’ve aligned themselves? Perhaps this can of worms felt too large for Brown to address in a memoir largely about her own experiences with breast cancer, but given all her analysis of modern healthcare’s shortcomings, the issue could’ve been pushed further. Plus, she seems to know that being a squeaky wheel is a privilege in itself: “The difficult patient attempts to yell her way through the noise of healthcare profiteering…sometimes it works, sometimes it doesn’t.”
Brown’s strengths shine in the re-creation of scenes, where her nursing identity comes to life through dialogue and patient-as-character descriptions, effectively establishing her credibility as a care-concerned (albeit self-invested) narrator not unlike Meredith Gray. The formerly depressed leukemia patient who turned up with a twinkle in his eye, for example, or the family friend, Matthew, who escaped the shadow of cancer in part due to Brown advocating for his pain meds.
She’s also skilled at owning up to her own humanity, saying that while people failed her when she was a patient, she also failed patients when she was a nurse. “I see that now,” she writes. “Can we try again?” Her answer to righting this wrong, in some ways, is simple: compassion-driven care. Put people before profit, serve everyone equally, and consider not just the sickness within a body, but the soul inside it, too. That answer feels both apt and like not enough, because it shows how much expectation we put on healthcare providers to enact widespread health, when in truth it’s the system itself that needs healing—and as with all societal challenges, that’s a matter not of individual action, but of corporate interest.
Still, Healing shows that a little compassion does go a long way. She never forgets the radiology tech who reminds her not to forget her hair tie. But compassion is complicated, too, like when her hospice patient, a woman with untreatable metastatic breast cancer, tells Brown, “I’m going to beat this, I have too much living to do,” and Brown replies, “Well, why not?” Knowing for certain that death already portends, Brown defies her commitment to scrupulous honesty and instead allows the patient to live her final days in hope, and as a result, happiness—which despite being a lie, might arguably be one of the greatest gifts you could give a dying person.
In her wide-ranging examination of fear, illness, and life in what she calls “cancer’s shadow,” Brown never fails to reveal her own humanity. Healing is a book not only for breast cancer patients and their loved ones, but for anyone else who cares about caring. Most importantly, Brown shows us the importance of perspective: how the value of compassion becomes infinitely greater when it becomes your own life that needs saving.
Healing: When a Nurse Becomes a Patient
By Theresa Brown
Published April 12, 2022