A Letter to Bernard Tyson, CEO of Kaiser Permanente, from a 34 Year-Old with Breast Cancer

Dear Mr. Tyson,

Last night, I spent 20 minutes on the phone with a pharmacist who called me to make sure that my pain needs are covered. Between surgeries and chemo, I had a whole lot of meds from a whole lot of doctors, and he wanted to make sure that I had everything I needed, and that I knew how to take everything that had been prescribed.

There are a lot of problems with healthcare in this country, and I am writing to thank you for running an organization that I see as part of the solution, and not part of the problem.

I’ve been a Kaiser member since my teens. I have always appreciated the ease of dealing with Kaiser; if I have a problem, there’s a clear number to call for advice, and all the doctors are in one place. I’ve also always seen Kaiser as very innovative: I was given acupuncture and biofeedback as part of a trial for migraine headaches at Kaiser San Francisco in my early 20s. I had my daughter at Kaiser Walnut Creek in 2010, where the staff is full of midwives and there are birthing tubs. We paid $200 for my entire delivery and hospital stay, and every one of my daughter’s well checks have been free. As it turns out, she needed hearing aids, and her visits with a top notch audiologist (shout out to Dr. Madory in Novato!) are fully covered. I have always been thankful for how easy everything is, and I’ve always felt that I received quality care.

But in June of this year my appreciation for Kaiser reached a new level when I was diagnosed with breast cancer at age 34. I felt something strange in my breast starting in April, and immediately went to my OB/GYN.

I have a family history of breast cancer (two aunts, two grandmothers, and — last year — my mother), and Kaiser completely paid to have my genetic testing done. Everything came back negative, but I was still put in a High Risk “Clinic” where I was given access to a talented breast surgeon in San Francisco (Dr. Langer) and started on a regimen of early screenings. Dr. Langer took time out of her extremely busy schedule to explain early screenings and personally called me when my baseline MRI came back “funny.”

Dr. Christopher Cappelen, a radiologist in San Rafael, was the one to do my diagnostic ultrasound and biopsy. He was the one who had the very unfortunate job of, at 4 p.m. on a Friday, telling a 34 year-old single mom that what she had wasn’t “funny:” it was breast cancer.

I laid there on that table, tears streaming down my face, telling him cancer wasn’t part of my plan, and he was so, so kind. I look back on it now, and I know that the ultrasound techs knew something was very wrong when they brought me into the screening room, but they thoughtfully explained the number of people in the room in a way that was designed to not scare the crap out of me. I was technically alone, without a single member of my family, but they gave me comfort in a way that I can’t describe. Dr. Cappelen talked to my parents on the phone and explained what was happening. I can’t tell you how much this meant to me, and how much anxiety it relieved over the coming weekend.

It is now November, and I have had a bilateral mastectomy with tissue expanders inserted, and just finished my first round of chemotherapy. When my chemo is over, I face radiation and at least one more surgery. I am Stage 2a. If I hadn’t gotten an early screening through Kaiser, I would likely not have lived through my 40s. What a terrifying thought.

Everyone from my extremely talented plastic surgeon Dr. Gurjala, to the nurses in the hospital in San Francisco (especially Michelle, Vera, Jimmy, and AJ), to the entire staff in the San Rafael chemo clinic, has treated me like a human being. My oncologist, Dr. Greyz, is so forward-thinking that she “prescribed” walks with tweeting birds because studies show this helps chemo patients, right alongside my chemo drugs. Your breast care coordinator, Vicki Landes, has provided me with emotional support, free resources, a support group, and a heart pillow for after my mastectomy. Your advice nurses have made me cry with their empathy.

It is abundantly clear to me through every step of this horrible, horrible experience that people at Kaiser honestly care about me, and that as an organization you are truly working toward an ideal healthcare model. The payment plan you provide at zero percent interest was another shocking discovery I made that relieved a suffocating amount of stress for me.

I am sure that not everyone has had the best possible experience with Kaiser (I mean really, read the comments section of anything, people have complaints about rainbows these days), but I wanted you to know that I, for one, have. I wanted to thank you and tell you that I trust Kaiser’s doctors and nurses, and I wouldn’t want to go through cancer with any other health insurance.

Health care in this country is a mess, Mr. Tyson, but I recognize how lucky I am that I have Kaiser, and I am immensely grateful.

Thank you to you and every single Kaiser employee who has treated me with respect and kindness. Because of early intervention and excellent health care, I’m going to beat this.

Sincerely,

Sara Olsher

The featured image is a photo a snuck of my breast MRI. Syonara, cancer.

Why We Shouldn’t Judge: What is Strength or Bravery, Anyway?

Last year, my mom was diagnosed with breast cancer. She had a lumpectomy and radiation and was very quiet about the whole thing. She put her head down and got through it without saying much of anything. At the time, it seemed like I was more upset about it than she was (I mean jeez Mother, I’d already informed you that you were not allowed to get it, and you were not following directions!).

Meanwhile, my diagnosis has upended my entire life. I’m off work. I’m telling everyone and their dog what this experience is like. Was she braver than I am for pushing through without saying a word? Should I be quiet or attempt to work through my treatment? Would that make me stronger? Or am I braver than my mom for sharing my experience? What is strength, anyway?

A lot of people get cancer. I’m sure everyone reading this has been touched by it in some way or another — if not personally, then by someone you know well. Five girlfriends of mine had/have it (four breast, one thyroid). My mom, two aunts, and two grandmothers had it (all breast). My cousin had lymphoma. And there are lots of acquaintances, too.

Yesterday, my earliest childhood friend came to visit. She had a different type of cancer at 29, and she handled it differently than my mom and I did. And last night, I talked with two friends who currently have breast cancer as well. Emotionally we’re all coping in different ways, and on top of that, we all marveled at how different our treatment regimens are. Three different women with three entirely different treatment plans, all tailored to our specific types of breast cancer. Thank God for modern science and how far we’ve come.

To me, one of the biggest lessons of this experience is we should never, ever judge another person or the way they handle a diagnosis like cancer. No two types of cancer are the same, no two people are the same, and no two people handle their diagnosis the same way. No one is stronger or braver than anyone else.

Some things make my experience worse, and some things make it better. The overall picture is that it is different, how I handle it is different and there is no “right” or “strong”  way to handle cancer, or anything else in life.

  • Getting cancer in your 20s or 30s is more serious than getting it later in life . . . AND I caught my cancer earlier than many people catch theirs and my survival outlook is far better than other people’s.
  • Losing my breasts and all my hair in the prime of my physical life is devastating . . . AND my hair will grow back and I am a candidate for reconstruction.
  • Having cancer when you have small children is different than if you’re single or have grown children  . . . AND I already have an amazing child, and I have not been robbed of the experience of motherhood.
  • Having cancer when you’re a single parent is scarier than when you’re married or have a partner you trust  . . . AND if something happened to me, my child does have a father and wouldn’t go into foster care, which would be way worse.
  • Having a double mastectomy, chemo, and radiation is different than having just one or two . . . AND my chemo regimen is not as aggressive as it could be, so it won’t be as hideous as it could be.

This list could seriously go on and on, and I am making this list specifically to shine a light on the fact that if any of these things were different, my experience would be entirely different than what it is now.

Everyone’s cancer, and their experience of it, is different. It differs by the age you get it, what type it is, the stage it is, the treatment you have, your support system, your marital status, whether you’ve had or want children, and your experience with the healthcare system.

No person’s way of handling their pain – emotional or physical – is any better or worse than anyone else’s. No one is stronger or weaker. We are all different, and we all handle things differently.

In the hospital and at every visit since, doctors and nurses have asked me to rate my pain on a level of 1-10. In the hospital I had a really hard time with my medications. They couldn’t seem to get my pain under control; if a medication worked to control the pain, it caused unbearable nausea.

At one point a nurse came into the room and apologized that they’d had such a hard time finding the right drug combination for me. At Kaiser, there is no one-size-fits-all approach to pain control, and there is zero judgement. I believe their philosophy can apply to anything in life, and I think it’s really important. Here’s what the nurse said:

We don’t ever attempt to judge people’s pain. We ask them to tell us how they feel, and then we alleviate people’s pain according to how they judge their pain. Who are we to say that one person’s pain isn’t as bad as another’s?

Everything in life, cancer and pain tolerance included, is relative to your own life experience. We all have different experiences with cancer before we get it. Having a good friend die of my same cancer profoundly impacted the way I have coped with my own. Had I not known her, this experience would have been different. Having a family history changed the way I dealt with it. So very many things affect how we handle every problem we face in our lives, and no way of handling it is better or worse than another.

So here we are, back to my original question – is my mom braver than I am because of how she handled her cancer? We’ve come to the conclusion that no, she wasn’t any more or less brave than I am.

We are all doing what we can to get through our lives, cancer included, and we’re choosing to do it in the way that feels the least traumatizing to us. For me, cutting my hair short wasn’t an act of bravery; it’s less scary to me than shaving it all off in one fell swoop, or letting it fall out in clumps. Sharing my experience with all of you isn’t an act of bravery; writing is how I cope with any experience in my life, and this (unlike my divorce) is something I feel comfortable sharing publicly.

I am starting not to believe in strength or bravery. We all do what we can, to the best of our ability. What do you think?

The gorgeous flowers in the featured photo were sent along with a yummy candle by one of Bear’s coworkers, Maddi, who I fell madly in love with last summer (shh…not sure if she knows the depth of my feelings). They allegedly came with salted caramels too, but I will DENY EVER HAVING SEEN THEM because OMG they were delicious.

What Being a Warrior Means to Me

This post originally appeared on Instagram and Facebook.

warrior-ring-for-women

When I went through my divorce, I never took off this warrior ring. It was a reminder that I could get through any battle I faced (and there were many). Soon after I met Bear, though, the ring broke. I was devastated. It felt like I’d lost something that had been part of my body for four years. I decided to look at it as a sign that I didn’t need to battle through life anymore, and I set it aside.

When I was diagnosed with breast cancer, I fixed it. That’s how you get through cancer, right? Like a warrior? But when I put it on, it didn’t feel right anymore. I couldn’t figure out why, and then suddenly I realized that there are two reasons this ring no longer works for me.

First off, I am choosing to look at my journey through cancer as healing, not fighting. I don’t need to be a warrior, I need to cuddle up in a soft blanket and let the drugs work & my body heal.

Secondly, the warrior on this ring is facing battle alone. Divorce can be a very isolating experience, and you’re alone a *lot* of the time, which you’re not used to. It is sad, and you need a reminder that you’re a warrior and you’ll get through it. But cancer has been different for me. I am privileged not to be alone at *all.* My friends and family and complete strangers have rallied around me to support me. I am not going into a battle, and I don’t need an army, because I have a tribe.

So with that, this ring is going back into retirement. It’s served its purpose, and I’m grateful for the support it gave me when I needed it. But I’m going to lean on my incredibly loving and generous friends and family now.

Thanks warrior, but I don’t need you anymore.