In Sickness and in Health

“It’s hard to do cancer by yourself,” said Liza Marshall P ’14.

Luckily, Liza had what came close to a dream team when she was diagnosed with Stage 3 triple-negative breast cancer at age 43. First, her husband, John Marshall, is a world-class oncologist practicing at the top-tier MedStar Georgetown University Hospital. She had access to top-of-the-line care, including physicians who were often also their friends; the Marshalls even live close to the hospital. She had access and benefits that some high-risk cancer patients dream about.

She also had a 50 percent chance of survival. At best.

On September 13, Liza and John discussed their new shared memoir, Off Our Chests: A Candid Tour Through the World of Cancer, at a Conversation with Friends event moderated by oncologist Ben Weinberg ’03. Liza and John wrote their chapters separately—some they didn’t share with one another until the very end of the publication process—to tell one deeply personal story. And while it was a shared history, the two remembered it very differently.

“All of the sudden you’re diagnosed with cancer, and you’re thrown into this world that you don’t really understand,” Liz said. “I understood what clinical trials were, but I didn’t understand which one I should choose to be in—or if I should be in one at all.” While writing the book, Liza looked back at one of her doctor’s notes in which the doctor wrote that Liza understood what had been told to her. “What I remember was I had no idea what anyone was saying to me.”

John, who has long been outspoken about how the dominance of breast cancer research and awareness was actively harming research into other, often deadlier cancers, now had to shift into a new role as personal caregiver to a breast cancer patient. He also had to keep working—the couple depended on his health insurance. However, when it came to Liz, he was clear he wasn’t her doctor.

“I really didn’t go into her chart,” he said. “I didn’t go into tumor board [when teams of physicians meet to discuss a patient’s treatment], though I was invited. I didn’t dig into the clinical trials. I just stood on the sideline and trusted the team that they would take care of her—and the team also took care of me.”

While the disease and the grueling, experimental treatment Liz underwent brought them together, there were moments of unavoidable emotional separation.

“There were a lot of things that we had thought of the at the time and even in subsequent years and had never said to one another” until they began the book, Liz said. “There are things you don’t want to say out loud because you’re worried about what reaction you’ll get. My main concern with John was that he was going to know what was going on with me, it was going to be bad, and he wasn’t going to tell me. There was this cloud of information out there, but it was like it was only raining on one of us.”

For John, it was a different kind of storm; one that continues to affect his practice.

“We were so spoiled by our doctors because they were our friends, and it was so comforting,” he said. ‘I thought, ‘Don’t we owe that to all of our patients? Don’t we owe that kind of access and immediacy?’” He soon began giving his business card to his own patients, encouraging them to call or email with questions. He also began working with MedStar Georgetown to hire more patient advocates and other experts who could guide cancer patients through their treatments—an effort to ensure that everyone has a dream team of their own.

In the end, writing Off Our Chests was a way to synthesize the memories, the technical jargon, the trauma, and the eventual victory.

“For me, writing the book was therapy; it was kind of my moment of silence with myself to really write out what I was thinking and feeling at the time,” John said. “And it was the therapy I needed. When someone you love gets diagnosed with cancer, you have to learn to live in kind of a free fall. It can take a long time to feel the ground underneath you.”


To watch the full Conversation with Friends recording, click here.

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