The Latest Happenings…

For the past two weeks, I’ve been seriously considering pulling out of graduate school. Something happened with the ravenous lion, and it was the last straw. I called my old boss and told him that I couldn’t do it any more. I was fighting just to exist as a student in the program. Graduate school is a lot of work and adding all the bureaucracy and politics, it was just too much.

I’ve spent the last two weeks on the phone and in the offices of friends, mentors, and school folks. I’ve never cried in front of so many people in such a short period of time. Things have been hard, folks. There’s no way around that.

So as I planned my exit strategy and started telling colleagues that I was leaving within six weeks, it hit home why I’m in graduate school in the first place. Of course, it’s nice to be paid to think and to study. Having health insurance isn’t half bad either. But the fact of the matter is that I love studying and teaching. Sitting in classes, I realized that I stick out like a sore thumb in the program. But also the work is unbelievably fulfilling. Teaching a lecture to 250 students on the physics of flight, participating in class discussions outside my field of expertise, and discussing my dissertation topic with various professors: it’s been a long time since an activity made me smile so much.

The conclusion? I’m staying, folks. It will be a difficult journey. It will involve a lot of fighting. There will be plenty of naysayers. But this is what I want, for me.

I got all the way up to 95% sure that I couldn’t do this any more. But at the beginning of this two week process, I told myself that I could stay if (1) I had someone to guide me through the milestones leading me toward my Ph.D. and (2) someone would fight alongside me. The ravenous lion has been refusing to allow me to move forward, arguing that I might not be physically capable of all the work. Now I have an undercover adviser who’s helping me think through classes, exams, and all those other milestones that make up this Ph.D. program. And Dr. Leo made some critical phone calls on my behalf. He called my official adviser and talked to him about each of their concerns, helping me gain some perspective and also informing the world that their actions are not unsupervised!! He called colleagues and made referrals so that I could take advantage of all the medical resources that are available in a timely manner.

My official adviser, Dr. Leo, and I all realize that if my medical condition takes a turn for the worse, it may no longer be feasible to be in the Ph.D. program. Dr. Leo and I are keeping an eye on that, and I will consider dropping out of the program or taking a leave of absence should it come to that. However, for now, it makes sense to stay, and more importantly, it makes me happy!

The next sixteen months are going to be hard. The workload is hard, and, to be honest, my health is not that good. But I have some pretty awesome mentors who are willing to have hour long phone calls with me and walk beside me through the journey. I have Dr. Leo who’s committed to helping me in a holistic sense, including helping me prioritize things in life to make the most of the gifts and resources that I have. I’m blessed with the opportunity to work at something that I love doing. I have friends who pray for me, even when I don’t know how to ask them to pray. And, I have a God who is caring for me in ways that are beyond comprehension.

Humbled, a little nervous, but mostly at peace,


He Said, Thank you so much

As mentioned before, I’ve had a million phone conversations recently. This week, they have been more of the 15-20 minute variety. But I’ve discovered that you can learn a lot about people in sticky situations.

Case in point: Dr. Leo called me this afternoon. Why? Because I sent him a message earlier today and asked him to. We talked about a lot of things, including this visit. Like I said, it was a straightforward conversation. But the thing that struck me most at the end was his parting words:

Thank you so much.

Wait, what? He’s thanking me? For what? I think this makes even less sense than me thanking Dr. Mark for listening without giving me an answer.

The thing about it was that Dr. Leo was very sincere. It meant something to him to be able to talk to me about my case & my life. It wasn’t just that he didn’t mind that I had flooded his inbox with emails. (Well, if you can flood an inbox by sending two emails in one morning.) It wasn’t merely that I picked up the phone when he called. I’m not sure what it was. But I’d like to think that somehow I can contribute to making his job just a little bit easier, and that makes me happy.


Touched by A Few Words…

I’ve been reading Scriptures with Alana some nights. Yesterday, we read the first half of Lamentations. Lamentations is just like what it sounds like. The situation is absolutely awful; after Jeremiah describes the terrible condition of God’s people, he proceeds to lament over their degraded condition. But in the midst of all the turmoil, this passage resides:

This I recall to my mind,
Therefore I have hope.
The Lord’s lovingkindnesses indeed never cease,
For His compassions never fail.
They are new every morning;
Great is Your faithfulness.
“The Lord is my portion,” says my soul,
“Therefore I hope in Him.”
The Lord is good to those who wait for Him,
To the person who seeks Him.
~Lamentations 3:21-26

Full of new hope,

Signs of a Terrible Doctor

…I know I said that I would be back in a week, but something happened today and I need to write about it. Writing is cathartic for me. Hopefully writing about it will make me feel better.

I saw a specialist this afternoon to follow up with the isn’t-cancer-but-is-still-lingering condition. The visit was terrible. I kept thinking, I definitely didn’t pay for your opinion on these issues & why are you only spending 2 minutes on the condition that I consulted you for??? Chronic patients need someone more than an expert; they need someone to recognize that their condition might be complicated and they may need extra assurance to follow through with a new treatment direction. They need someone who listens to them and cares for them on a human level; otherwise, how do we know that you’ll treat us well as scientific subjects?

Dr. Voluble met all these criteria for being a terrible doctor; (my responses are in italics):

1) Diagnoses you before he talks to you or examines you by skimming through your file

I call doctors like this scientific. Maybe a better descriptor would be robotic. They stereotype your case into one of three possibilities; (interesting how by virtue of walking in the door, you have one of three conditions!) If I wanted a generic evaluation like this, my physician would have ordered a phone consult.

2) Doesn’t actually look at the notes in your file for why you were referred & doesn’t take notes at all when talking to you, especially for a thirty minute conversation

One of my pet peeves is when doctors don’t look at my medical chart and then proceed to ask me questions about things that are clearly stated in my chart. I understand that you want me to tell my story in my own words, but don’t walk in and then ask me if I’ve ever seen other physicians for this condition. The answer is: Yes and WHY haven’t you looked at my chart??? Plus, you clearly don’t value my thoughts enough to actually be noting down anything I’m saying, so are you really listening or did you just walk in to dump your pre-ordained diagnosis on me since insurance won’t pay for this consultation unless you actually talk to me?

3) Tells you when he enters the room that while he knows that you came in to discuss something in his speciality, he wants to set that aside for now and talk about other things because he thinks those are more important

This is a terrible, terrible sign. It would be like taking your dog to the vet and the vet giving you a thirty minute discussion on topiary. Ummmm, I don’t really care if the way my backyard is laid out is stressing out my dog. I came here to see about the thorn in his foot!! And if my topiary is really a problem, I should be talking to a gardner about making changes to it. Can you please pretend to take me seriously? I’m consulting you about something in your field of expertise because it’s important to me to understand what’s going on there, and another physician believes that your expertise would be beneficial.

4) admits that he’s not a psychiatrist (or other type of specialist) but claims that in my case, he knows more than they do

Another terrible, terrible sign, especially since I have something that is not straightforward, which he would know if he actually looked at my chart!

5) mentions how many years he’s been in practice & how many patients he’s treated

If you have to revert your personal history in order to establish credibility, something is wrong. Your credibility should be based on logic of how you came to this conclusion and the signs and symptoms present in the case. If you’ve treated a million dogs for schizophrenia, it doesn’t make you a better vet for removing the thorn in his foot!! He’s not schizophrenic and definitely not the other million dogs!!

6) when you mention that you have other physicians that he may want to consult with, he replies that actually he doesn’t need to consult with him because he knows that he’s right

Another terrible, terrible sign. If the only reason that you’re running a diagnostic test is to prove to me that you’re right (especially about a pre-ordained diagnosis), your credibility is going way down. Experience tells me that if the diagnostic test comes back negative, you’re still going to want to treat me for what you think I have because “tests aren’t really that accurate”. This is not the proper use of science in medicine; science means that you follow a protocol that makes sense in this case, not a protocol that is one of the three options you always exercise.

7) corrects you when you try to explain your medical history and your explanation doesn’t fit his pre-ordained diagnosis

Something about this tells me that you’re not listening to me and you don’t actually respect me enough to accept the possibility that there may be something you’ve overlooked.

8) spends a total of two minutes on the physical exam and the actual issue you came in for and spends another thirty minutes talking about things that are either outside his medical speciality or not even related to medicine!!

I left this visit completely uninformed about the issue that I came to consult with this specialist about. I know it’s not cancer, but I already knew that before. I still don’t know if there’s something abnormal because you didn’t spend enough time to determine that and you didn’t even look at my face during your two minute exam. If I was grading you, you would get a 0 because you failed to meet the demands of the assignment.

9) insults his patient’s intelligence by repeating everything over and over again and refusing to address legitimate concerns of the patient

Just because I have a chronic illness doesn’t mean that I have the intelligence of a twelve year old. Neither does the fact that I might look like I’m twelve. I’m in graduate school and provided you with the majority of the information that you’re using to make this diagnosis (since you failed to examine my chart.) Plus, I was referred to you by another M.D. for something that he felt was serious enough to merit a consultation with a specialist. If you dismiss the reason that I came to see you, you are effectively dismissing his judgment. Since he’s spent a lot more time with me and I have an established relationship with him, this also diminishes your own credibility.

10) spends so much time off-topic and away from medical issues that the patient has to politely but firmly nudge him, Can we not talk about this any more?

There are no words…

11) knocks on the door after he already opens it even though the whole reason he left was because proper medical protocol requires a female present for the actual exam

You’ve established that you think you rule the world. You don’t have to demonstrate it again.

12) is sure that his pre-ordained diagnosis will totally turn your life around and knows that only a great mind like his would have seen this

I’m sorry, but even if you’re right, I’m electing for treatment with someone who respects me enough to listen to my concerns, thinks about how this might fit into my existing treatment, and honors my intelligence and decisions. And, so far, you haven’t done a very good job at establishing credibility; I just know that you think you’re really something.

This visit reminds me again and again how blessed I am to have physicians like Drs. Leo, Mark, & Samuel in my life. I know that I can bring up the issue that Dr. Voluble flagged to any one of them, and we can discuss whether or not it’s something that needs to be investigated. They will take the time to listen to me and consider this issue because I brought it up and asked for their help. If it’s not something important, they’ll tell me so and tell me why. Then we can move on. And if it’s something that needs to be addressed by someone who specializes in that issue, they’ll refer me to a colleague. They won’t spend time criticizing Dr. Voluble or dismissing my feelings regarding this consultation. They won’t tell me that they’re not interested in an issue that I bring to them. And something tells me that this makes them better doctors. It certainly makes me feel less stressed about managing my own very complicated medical journey.


My Phone Battery

I made a lot of phone calls this week. A lot of them have lasted about an hour. My phone has great reception and a fairly long lasting battery. I really can’t complain much. But this week, it keeps running out of battery charge. And I’ve realized that it’s because I’ve been talking to people via my phone for hours at a time.

It’s been great actually. I’m so thankful that I have friends with whom I can talk and reflect, cry and rejoice. With all the potential changes in the air, it’s been really helpful to get support from all kinds of different peoples. From everyone like Drs. Leo & Samuel to far-flung friends like Alana and Tabitha, persons such as Lydia and Aaron, Gregory and Diana, I’m glad that there are people rooting for me and making sure that I’m not doing this on my own.

Ever grateful,

Just a Quick Update

to say that things have been super crazy, and unexpectedly so. It looks like I’ll be making some pretty major life decisions in the next week or so… and I’m kind of scared (to be honest). I’m not ready to write about them yet, but know ye here that all of them are regarding issues already discussed on this blog.

I appreciate any and all prayers, good thoughts, and support during this time. I’ll be back in a week or so with more concrete news.


Sometimes Life is Just Hard

I left my house yesterday at 10:30 am and didn’t make it back to around 4 pm. I had a doctor’s appointment, ran an errand, got my car inspected, and stopped at someone’s house to talk about church matters. It didn’t seem like a whole lot of activities. But I’ve been drop-dead exhausted since then.

I’m sure it would have helped if I ate lunch somewhere in those 5.5 hours. It probably also would have helped if I had skipped dinner with my roommate and her parents (or somehow avoided that feeling of depression that hit me the minute after we sat down at the restaurant.) I don’t think the intense conversation with the doctor helped. Neither did the heart-to-heart discussion/critique with the church lady. But still. It’s real life. These things happen. It’s not too much to have them all happen in one day. Or is it?

I’ve basically been in bed resting since the dinner. School starts on Tuesday, and I feel like I need to be doing a whole lot better. And in the back of my mind, I’m wondering if this whole graduate school thing is really a good idea.

At the same time, I wonder if I should be cutting myself some slack. It’s been a crazy month. Realizing that the breast pain that had been haunting me for a month was not normal and seeking medical counsel. Discovering that I probably have a breast infection… the subsequent it’s probably not cancer but keep an eye on it. Visiting a doctor at least every day for almost two weeks straight. Having conversations that included “you must go to the urgent care clinic right now because those are symptoms of a heart attack” only to find out that the horrible chest pain was only “costochondritis” and not much can be done about it (except to monitor it and make sure that it’s not actually a heart attack!) Having people tell me that they can’t believe that I’m still sick. Having other people like Nora offer to fly out here to hold my hand if it turns out to be more serious.

Then, if that hasn’t been enough, my new roommate also moved in this month. I filed a discrimination claim with the university regarding my graduate program. My sister announced that she was moving across the country instead of across the ocean, and she was leaving in days, not weeks. Realizing that the stalemate with my parents had actually gotten worse (something I didn’t think was possible). Seeing Timothy & Grace off and then realizing that my ties to their church was tenuous at best. Emailing, then calling, then accepting a visit from Aaron after I confessed that life itself was harder than ever & I needed help. Seeing four different doctors in one week and grieving with each and every one of them.

On top of all that, depression inflates the isolation I feel by being housebound and misunderstood. As much therapy and medication as I’ve undergone thus far, sometimes it can still be overpowering.

So maybe, it’s not that surprising that I’m exhausted. It’s been a hard month. Lots of tough stuff happening. Lots of difficult conversations: some of them I wish didn’t have to happen and some of them that I’m glad I had the courage to initiate.

Is it too much to expect that the gravity of it all will just disperse when school starts? And the pain will just go away? But what’s a girl supposed to do?


When Doctors Grieve with You

I’ve been in and out of doctor’s offices every day for the past two weeks. It’s been a draining experience. But this one moment with Dr. Mark is stuck in my mind.

Yesterday, it was the end of yet another appointment in the XXXXL exam room. It seemed like we were always rehashing the same things: symptoms, medications, options, short-term plan, things to look out for. We had joked a little bit about the new computer system and how certain things were counterintuitive. But mostly the gravity in that room dominated.

So it was that when he was leaving, he took a moment to look at me and whisper, I’m sorry. As relieved that we were that I probably don’t have cancer, that look acknowledged the frustration that we both felt of not knowing what was wrong and having little control over the situation. Something in that moment gave me the courage to ask one more question: Is there anything I can do to cope with the pain? Any medication that will give momentary relief?

That moment stopped us both in our tracks. How did he know I needed to see his sorrow? Where did I find the strength to speak up?

Five seconds. A moment of mutual grieving. Acknowledging the loss in my young life. It changed everything. This is why:

It takes guts to admit that we don’t know everything, especially in your own field.

It takes effort to show that vulnerability to someone else.

It means stepping out of the superhero role into the victim box.

It means recognizing that life is not perfect and that some times things are hard and out of our control.


It also means the patient knows the doctor is listening because he cares about the patient as a person.

It also means the patient knows the doctor is doing everything within his power to help.

It also means we’re all in this together: the patient and the doctors: we work, we rejoice, we mourn, we feel.

It also means in that moment when the patient needs it most, there’s someone intelligent, knowledgeable, and human there, come what may. That’s the foundation of courage that is needed to face something difficult and bigger than you. It makes all the difference.

~Abigail Cashelle

Because It Matters

“…because it matters to Him concerning us.”

The past days have been really hard. A lot of things are in limbo, and somehow everything seems so much more urgent.

Talking to Aaron this morning though, I realized that while it may be advisable not to panic and to relax, it’s okay that I’m scared and feel incredibly vulnerable. Aaron asked about my schedule and what things were going through my mind. But it wasn’t because he was trying to evaluate how needy I was. He wasn’t figuring out whether I was making the “right” decision. He wanted to know about me, how I was feeling, what was occupying my time, and what I needed.

When I saw him at vespers later, after he greeted me with peace, he asked how the rest of my day went. I gave a non-committal answer: pretty much the same as when we last talked. It wasn’t so much the conversation or the words. It was the sentiment. Here in front of me was someone who cared about how I was doing. If I was reserved, serious, and kind of quiet, then he just wanted me to know that he remembered me and was available.

It reminded me so much of God’s promise. In Aaron, I saw a picture of God’s specific care for me (as opposed to the things in my life.) I just stand in awe of God’s work in my life. He’s marvelous.

Casting all your anxiety on Him because it matters to Him concerning us.
1 Peter 5:7

Blessed beyond measure,
Abigail Cashelle