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The Next Phase

Yesterday I sent an email to some of my work colleagues that have made significant contributions to my career over the past three years. The email is as follows:

I have addressed this email to those who have been instrumental in my medical care over the past few years, and those who have been instrumental in supporting me professionally as I have navigated the first three years of juggling my work as a Junior Doctor juxtaposed against my role as a patient.  

Most of you have probably read in the media about the latest developments in my health and my expectant fatherhood in January, but I wanted to personally inform you about where things are at, as well as extending my heartfelt gratitude for your contribution to my short lived career. 
Two weeks ago I made the incredibly difficult decision to take indefinite leave from my job. As you will likely be aware, I have had aggressive recurrence of disease in my liver between my two most recent CT scans (between which I had 25 fractions of 45 gray radiation to retroperitoneal disease). This has necessitated starting a new regime consisting of agents I have had previously (FOLFOX), and the not-publicly-available monoclonal antibody Bevacizumab. I have completed two rounds of this, and it has resulted in the almost inverse of my well:non-well time ratio. 
Previously on FOLFIRI, for which I completed 66 rounds, I usually found I had 5 days of downtime and 9 days of up time each fortnight. This has enabled me over the years to continue with my medical studies and graduate, and then to complete 3 years as a house officer. I now find that on this new regime my unwell time has extended to close to 8 days, with only 5-6 days of being well each fortnight. I have also found that during my well time, I do not have the same level of energy I once had. After much reflection, I realised that it wasn’t fair on my colleagues and my patients for me to keep working when my attendance was so infrequent, and I wasn’t able to give the 150% that the job deserves and that I want to give. It was a heart breaking decision as I had also been offered a General Surgical Registrar position starting this December, and this for me was the job I was born to do. I now feel that I have entered the next phase of my illness and only time and the next CT scan will reveal its exact course. 
I wanted to send this email because there have been many many people to whom I am so incredibly grateful for their contribution to either my medical care or my professional career. These people consist of surgeons who have operated on me, and those I have operated alongside; those who have treated me clinically; colleagues I have worked alongside; and referees that have helped enable me to be offered the job that ultimately I will never start. The journey over the past 5 years since my initial diagnosis has been difficult, but to be able to continue to study and then work in an area I am so passionate about has, I am certain, enabled me to survive longer that anyone could have predicted. 
There is no doubt I am a statistical outlier, and perhaps we will never know why, but my hope is that I might continue to be one. The decision to take indefinite leave rather than resigning was with the faint hope that maybe one day I might step back into the role of the Doctor, but all things being equal, I feel that I have likely treated my last patient. 
We are all dealt different cards in our lives, and I want to thank you all from the bottom of my heart as you have helped me play my hand the best way I know how. 
Humbly grateful, 

The decision to stop working has been one of the hardest decisions of my life. For me my medical career wasn’t just a passion, it was a choice of vocation that goes to the core of who I am. It was a God-inspired decision to go to medical school, and I believe, a God-given strength to be able to finish, qualify and work whilst being treated with chemotherapy. What tipped the scale to stepping down was the realisation that as a patient, I would want a Doctor that could give more than I can currently give with my new treatment.

That realisation led me to tears….

This feels like the beginning of the end, the down hill slide to the bottom.

I will still persevere though, I will maintain my practicing certificate and I will reconsider this decision should the circumstance allow it. For now though, I need to focus on the next phase of my life. The next CT scan will help determine what that next phase will look like, but the one certainty that remains is chemotherapy and a probable slow deterioration in health.

The key thing for me is to do this well. All of us are eventually heading to the grave, and whilst I will be there sooner than most, I have the chance to make that journey the best it can be.  

Until next time…

Categories: Blog
  1. November 25, 2013 at 4:41 pm

    Thanks for letting us into in your story Jared. You mean more to us than you will ever know.

  2. November 25, 2013 at 5:40 pm

    Thanks for sharing this email, Jared. We all know that your colleagues. med. students and patients have benefited enormously from your journey in medicine, on both sides, but we are still very grateful that the decision makers decided to invest in you. It’s a testament to them but also to you.

  3. Janice Roseingrave
    November 25, 2013 at 6:15 pm

    Thanks for sharing your latest update Jared. I hope that the next CT scan heads you in a positive direction. Regards to you both, Janice

  4. Jess
    November 25, 2013 at 6:24 pm

    I’m sorry Jared that you have had to make this call, you’re so thoughtful and I have no doubt you will continue to give of yourself to others. So proud of you.

  5. Nicole Jenkins
    November 25, 2013 at 6:27 pm

    I feel incredibly fortunate to have been one of the many patients you have cared for. You have had a big impact on my life. Thank-you Dr Noel 🙂 I hope that the fact you are having a tougher time with this treatment means the cancer is struggling too. Take care xo

  6. Catrina Bregmen
    November 25, 2013 at 8:26 pm

    Hey Jared

    I’ve been following your blog since my own cancer diagnosis last year. Although I first saw you on 20/20 & I recognised you from Rangeview.

    I’m sure you were with my surgical team earlier this year. I’m on Prof Windsor’s team & I’m pretty sure Nick came in to do rounds one morning & I’m sure you were tagging along.

    I know god has you the same way he has me. He lead you in the direction of medicine for a reason. Not everyone can say they completed a medical degree while undergoing chemo. I don’t know anyone who has been both patient & doctor at the same time & I can’t imagine how hard it’s been for your team of doctors & nurses to both work with you & for you at the same time…

    What a hard decision to have to make to give up the job you love.

    I pray for your yet to be born daughter. I pray that you get as much time as you can with her & that Hannah, baby & yourself get some quality, happy time together before our Heavenly Father takes you home.

    Hannah (and the rest of your family) will make sure your daughter knows how hard her daddy faught both for her to get here & how hard he faught to stay. She will know you see her from heaven.

    I pray that this medication has it’s desired effect & God gives you the time you need.

    Please keep fighting & writing…

  7. Clare
    November 25, 2013 at 9:58 pm

    You are a total inspiration to all mankind.
    I have no words to express the admiration I have for you and your wife.
    God bless.

  8. Renelle Gronert
    November 25, 2013 at 10:22 pm

    Blessings to you and your family; prayers for lives as long as god blesses us to have; for the gift of living very day like it was our last. And thank YOU for your time and output which inputs to us all as a testament to you and your faith.

  9. Heather Ameye-Bevers
    November 25, 2013 at 11:00 pm

    Hey Jared,
    Thanks so much for sharing your journey with us. I don’t get to see you that much but I feel that this is such a precious time to be partnering with you in prayer and in thought. You bravery and honesty inspires me and my kids to live our faith authentically with no easy cliches – just the truth and the faith He has given us.
    God bless you and Hannah and baby girl.

  10. Jono
    November 26, 2013 at 9:42 am

    Mate I can understand the hurt you must feel having to take leave from something that God has led you to do. The inspiration that you inspire in others has been a constant source of inspiration for others to pursue the passions of their heart. I know for myself this was the case when I decided to return to the classroom and have pursued that dream. I don’t believe God will allow you to slide to the ‘bottom’ as you say… Hopefully it will be a Blaze of Glory as Bon Jovi sang back in the early 1990s for the Young Guns 2 movie.


    Jono & Tui

  11. November 26, 2013 at 12:04 pm

    Jared, best of luck with the treatments! I’ve always been amazed how you can go through chemo treatment while working the hours as a doctor. You do what you need to do, including stop working when necessary and I trust that you’ve lived your life to more than the fullest. 🙂

    Best wishes to you and your family!


    November 26, 2013 at 11:36 pm

    What a hard decision to make, thank you for sharing that email with us.
    Sending loads of strength and prayers across computerland.

  13. Dyana Parore-Connell
    November 27, 2013 at 4:54 pm

    Thankyou for this update. I dont know what to say other than the fact, I agree /share all the comments that have been put here before me. Thinking of you, best wishes to you and Hannah. God Bless

  14. Alyssa
    December 11, 2013 at 10:51 am

    Hi Jared,

    I stumbled upon your blog trying to research an issue related to my own health. I am 35 years old, a fit and healthy women, but then the flip side, I am a living with a terminal cancer called Multiple Myeloma. Somehow your blog popped onto my google search about relapse and here I am. I find your story powerful, and moving, but it also speaks to me on a personal level as my career pretty much hit a brick wall February 4, 2010 the day I was diagnosed, 6 months after graduating from university with my business degree, I had gone to nightschool for 8 years while working as a secretary, finally got a management HR job (my goal) and then I got sick. I lilve in Canada, and a few years after my diagnosis connected with a group here called: Young Adult Cancer Canada. It’s a blessing for my husband and I to conect with others dealing with same issues we deal.


    • Jared
      December 11, 2013 at 11:12 am

      Hey, I am sorry to hear about your diagnosis. I can certainly relate to being young and with cancer. I’m glad you have a group like that in Canada, we don’t really have one like that in NZ, but I have managed to connect to a number of people here who have a similar diagnosis to me which has helped. I wish you all the best with your treatment and future. If you want to stay in contact, feel free to find me on Facebook. 🙂

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