A Simple Twist of Fate
by Dr. Kelly Curtin
My Improbable Survival of Stage 4 Cancer
by Dr. Kelly Curtin
I’ve always despised the trope of the patient who pulls through against all odds, despite all evidence to the contrary. Yes, diagnoses can shift and treatment plans evolve, but the ultimate trajectory rarely strays far from the original suspicion. Still, I understand why those stories resonate.
As a resident, I cared for a teen who got a night off from treatment to get married, and another who went to prom with blood cells packed in a cooler. Both got one night to feel normal, to pretend they weren’t dying. I wish these stories had happy endings, but they didn’t. It’s comforting to believe everyone gets what they deserve, that strength and hope alone secure recovery. I wish it were true but these heart-breaking cases shaped my skepticism about miraculous recoveries.
Despite these misgivings, this is one of those stories.
A year ago, I was told my life was nearly over. The words were couched in uncertainty, but the implication was clear.
“It looks like metastatic cancer.”
“It doesn’t look good.”
“You might be ok or you might die; it’s a coin toss.”
My doctors didn’t say it was definitely bad news; it just looked like really bad news. I knew this move, soften the certainty and cushion the blow. I felt for my doctors having to deal with my sad case. No one wanted to tell a mom with kids at home that she’s going to die. I was trained to say the painful words like “cancer” instead of softer words like “mass”. Be honest, even when it feels cruel, because the worst pain comes when hope turns out to be an illusion.
After a few weeks of circling the drain, my condition began to improve after surgery. My cancer isn’t treatable with chemotherapy, so I only started immunotherapy. No circulating tumor cells were detected in my blood. Follow-up scans showed no new lesions and one improved lesion. My kidney and liver function returned to normal. My genetics were normal and bone biopsies were unexpectedly negative.
Yet given my ominous scans, every “good” result was treated with suspicion. False negatives were a real possibility. My oncologist suggested some findings might be explained by benign bone islands. She called it optimism; I called it delusion.
Now, I need 2 more days of tests for final clarity of my treatment plan.
Day 1: I arrive for my isotope injection. I pass a few hours working in the cafeteria, and then return to radiology to start the bone scan. The monitor on the wall shows a scattering of dots that I can see as the scan progresses. I make a conscious effort to avert my eyes. There is nothing I can do about this and looking only worsens my scanxiety. A few more days of ignorance won’t hurt me. My oncologist is out of the country but we agree that I will no longer read my reports without her. I will just be the patient.
Later that night, my phone rings. It’s the hospital and my anxiety spikes. There’s no reason to call unless there’s a new urgent finding. The worst scenarios race through my mind.
False alarm – just a scheduler calling to confirm another appointment. Exhausted, I collapse for the night.
Day 2: I know the drill and I go down my checklist.
🗹 Drive to another facility, silently and alone.
🗹 Point out the “best” vein to the tech.
🗹 Recite my unfortunate medical history and most recent creatinine.
🗹 Reassure the nurse that I’m coping fine.
🗹 Repeatedly breath-hold 10 seconds at a time in the MRI machine until the voice says, breathe normally again.
🗹 Remove IV.
🗹 Text smiley face emojis to my worried family.
🗹 Pretend to eat dinner. Smile so everyone at home feels reassured.
I’ve lived this day so many times this year.
Yet another torturous day dawns waiting for the verdict. My daughters observe me closely for clues if I have any results that I’m not disclosing. I try to de-emphasize these tests and their importance, but they know. All year, I’ve just prayed for mercy for my girls, a chance for them to grow up with a mom. I never told them how bad the bad news was, but they know.
Moms with cancer don’t get breaks and I go to work as usual knowing I could get the results call today or it could be a week. I make sure my airpods are charged in case my results warrant a longer, private call. I find myself still repeatedly holding my breath over and over again, just trying to tolerate it 10 seconds at a time. I remind myself to breathe normally again.
When the call comes, it’s earlier than expected, too soon for good news. My heart sinks but it’s not my oncologist. It’s someone calling on her behalf. She wouldn’t outsource unfortunate news to someone else.
The scans are stable. Treatment will end next month.
I expect a wave of relief, but it doesn’t come. I’ve won the incurable cancer lottery, but I don’t believe it. Perhaps now I’m the delusional one. I feel like a bit of an impostor, a stage 4 cancer patient who didn’t lose her hair, didn’t endure chemotherapy, and might recover. It doesn’t feel earned.
I turn the facts of my case over in my mind. I think about the lytic spot in my spine, so close to my kidney tumor. How can that not be cancer? It’s not a miracle but it’s pretty close. I want to celebrate, but I’m afraid. I’ve been fooled before. My younger sister survived her own kidney cancer, only to lose her life to blood cancer later in childhood.
That loss taught me a brutal truth; survival is never guaranteed. I am reminded that medicine is as much about uncertainty as it is about science. The stories we tell (of miracles, near-misses, improbable recoveries) aren’t about guarantees, but about how we live in the space between fear and hope.
I look at my surgical scar, six inches long plus five smaller ones, reminders of the surgeons and robot that removed my kidney. It tells the real story. I have been cut open and stitched back together. I have been wounded and mended, but I am not broken.
In this improbable year of gratitude and survival, one truth stands out: fate doesn’t care about our expectations or experiences. It doesn’t bend to our plans or our sense of fairness. It isn’t swayed by how much we’ve already endured or how much more we think we can take. It simply unfolds.
Though I have walked through the valley of the shadow of death this past year, I sit at my kitchen table today, daring to make tentative plans for the future. Even if my luck reverses again, I am still here.
And for now, that’s enough.
Kelly Curtin, DO FAAP CHCQM is a pediatrician and writer whose work explores illness, motherhood, identity, and trauma. She brings clinical insight and personal experience to essays that examine what it means to be heard, to survive, and to live without regret. She recently co-authored a children’s book, Molly & Potato, with her daughter—a tender story about love, loss, and the healing bond between a girl and her dog.
