Dear Reader,<\/p>\n
![\"Anna](\"http:\/\/www.bmj.com\/channels\/icons\/anna_donald.jpg\")
I should introduce myself before launching into a blog which I hope is not too depressing: living in the shadow of death. This is my starting point, as I was diagnosed with metastatic breast cancer (I lit up “like a Christmas tree” on the scans) in February 2007. It was not a complete surprise – I’d had primary breast cancer – not terribly high risk – in 2003. But disappointing that so much treatment hadn’t cured it. <\/p>\n
Since then, I’ve had more treatment and have returned with my husband to Sydney after 17 years in London, Boston and Oxford (I first came to Britain as a Rhodes Scholar). I am slowly adjusting to the art of living one day at a time. Not my usual style to put it mildly. My prognosis is dismal, but I’ve come across sufficient, well documented \u2018miracle’ cures (including Ian Gawler, a vet and friend in Australia who recovered from advanced sarcoma minus a leg, and who now runs courses for people with cancer) to convince me that recovery is possible. The question is, is it possible in me? I feel like a 19th century scientist trying mushrooms and vapours on myself, to see if anything gives. At the same time I know the literature better than I’d like to, in the circumstances, and don’t want to live in denial of the fact that 99.999% of people in my situation die fairly quickly. So I’m learning to live in an uncomfortable, ambivalent space of knowing-not-knowing which is fascinating, humbling and maddening.<\/p>\n
In my previous life, having completed my houseman year, I helped to develop evidology (evidence-based medicine) from its early days in Oxford. With degrees in medicine, history and economics, I was interested in health policy reform. I returned from a stint in the US to work as a public health and policy lecturer at UCL; was one of the first Clinical Editors of the BMJ’s Clinical Evidence, and then, for the next 8 years, was chief executive of Bazian, a company I founded with Dr Vivek Muthu to provide high quality scientific evidence to health systems (mainly the NHS) and to publishers.<\/p>\n
That life ended last year. So I’ve needed something else to do apart from read all the books I never had time for. On a recent trip to Sydney, the former editor of the BMJ, Richard Smith, encouraged me to write a blog documenting what it’s like to face life-threatening illness as a doctor who has been so involved with the EB world, among other things. Last year, I wrote one of the Opinion columns for the Health Services Journal, which I enjoyed, so I thought I’d follow Richard’s advice and give writing another go. Also, it’s probably the only thing I can do, come hell or high water (recently I was scribing away in the High Dependency Unit following brain surgery for a particularly accessible brain metastasis, although the writing kept veering off at a slant, which happily resolved the next day).<\/p>\n
I hope to write about things that may interest doctors, other health workers and policy makers about what it’s like to have life threatening disease; to be on the other side of the doctor-patient divide, and to experience 21st century health care for a chronic disease (Sydney’s hospitals are pretty similar to Britain’s), from a quality-of-care perspective.<\/p>\n
If you are moved to reply to this blog, please know that I appreciate feedback and am limited, given ongoing and unpredictable treatments, in being able to reply promptly, if at all. Please forgive me if I am not as reliable as I would like to be in correspondence.<\/p>\n
I hope you enjoy the blog.<\/p>\n","protected":false},"excerpt":{"rendered":"
Dear Reader, I should introduce myself before launching into a blog which I hope is not too depressing: living in the shadow of death. This is my starting point, as […]<\/p>\n