I loved “The Fault in Our Stars.” Both the book and the movie. I read the book a few years ago during a flight. I cried so hard that I’m sure the other passengers were alarmed, if not downright uncomfortable sitting near me. This summer, I saw the movie with a girlfriend. Same thing – I went through a whole pack of tissues and left red-faced, swollen and physically dehydrated.

As we walked out of the theater, my girlfriend (also a pediatrician) turned to me and said skeptically, “I don’t get it, Abby. Why are you so emotional? Isn’t this what you DO for a living?”

The answer is yes. Taking care of teens and young adults with cancer is what I do. And, perhaps, that is why this book/movie hit me so hard. For one thing, we oncologists are often so busy thinking about chemotherapy and side effects, we don’t see the other side of cancer. We get to know our patients and families, but we see them in the contrived settings of clinic and the hospital – not at home, amongst their friends or on a trip to Amsterdam. We aren’t always privy to their witty internal monologues or their poignant observations about the injustices of life, the things that really matter to them, or the life lessons they’ve learned during their arduous journey with cancer.

Perhaps more importantly, we also know the very real risks that come from a cancer diagnosis and treatment. We stand beside our patients throughout their journey, hoping and fighting along with them for a cure. When that cure doesn’t come (or when it comes but then goes away), we are crushed. We mourn. And then, usually, we rage. We fight on with the next patient. It is, for many of us, WHY we do what we do.

As my girlfriend posed her question, I started to think more about my reaction to the story of Hazel and Augustus. I knew from the first page how the story would end. I knew it would be sad. And (spoiler alert) I knew someone would die because, after all, death and sadness sell. The fault in “The Fault in our Stars” is this: thanks to clinical advancements in recent decades, most kids and young adults with cancer survive. And at Seattle Children’s, survival rates are even higher than the national average for all forms of childhood cancer combined.

Most of their stories are not about how they die, but rather, about how they live. The other, more common story of cancer is the one about how patients navigate new roles in their families, with their friends and at their schools. The one where they learn about themselves and who they want to become after cancer. The one where they (ultimately) celebrate life.

Augustus says his greatest fear is “oblivion.” Of being forgotten. And Hazel, in her tear-inducing eulogy, tells him how he will be remembered. How he left a mark. In my experience, patients don’t have to die to leave a mark. They don’t have to be witty or insightful or argue with random authors in Amsterdam. They just have to be. Every single patient I have ever met has left a mark on me. It is a great privilege to journey and (most of the time) to celebrate with them.

Dr. Abby Rosenberg is the medical leader of Seattle Children’s Adolescent and Young Adult (AYA) Cancer Program. She is also a researcher in Seattle Children’s Research Institute’s Center for Clinical and Translational Research.

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