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A Piece of My Mind
February 13, 2013

Portrait of an Artist

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Senior Editor.

Author Affiliation: New York University School of Medicine, New York, New York (robert.spencer@nyumc.org).

JAMA. 2013;309(6):557-558. doi:10.1001/jama.2012.217484

For the last five weeks since your death I have been writing about you, effusively expressing my gratitude to you and celebrating the way you humanized cancer for me, Nicki. I have spoken somewhat grandiloquently of compassion and the art of medicine, and of how you let me get to know you beyond your tumor. I meant every word of what I wrote, but grief is a funny, shape-shifting thing. My bold proclamations of gratitude now seem overblown and cloying, like self-congratulatory bravado, and my revelations about authentic patient care now appear dim, sophomoric, and one-dimensional. I have written many different versions of this letter—why can't I say just what I mean? Gratitude, sure, it's there: thank you for inviting me into your life, for teaching me about your art, and for telling me what it is like to have cancer. But what do I do with this sense of profound loss, of regret, of guilt? I tell medical school advisors that I want to be a pediatric neurosurgeon, and they advise me to “desensitize” myself to death; right now, I cannot imagine this, nor can I imagine it is a good thing, however necessary it might seem. I’ve said you brought the human element into medicine for me, but now I am not sure how I will ever be a physician and human both at once. Grief is messy and unquantifiable.

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