I didn’t know when exactly I wanted to become an oncologist. It became fascinating after several years into my training, before I started an attachment in oncology. It seemed to combine skills I’d developed along the way. These things always appear to have a narrative in retrospect, but it was random noise at the time. Oncology had molecular biology, science, clinical trials, and a very strong interaction with the patient.

A diagnosis of cancer strips away the nonsense in conversations. You don’t talk about the weather; you get down into the nitty-gritty of someone’s life. Now we keep people alive for years, so it becomes a very close relationship, which I’ve gained from enormously and hopefully my patients have, too.

Life Outside Medicine: Humor and Personality

If my wife or best friends described me, I think the first thing they would say is that I have a sense of humor. Almost everything can be turned into something that makes me or someone else laugh. Even a trip to SuperTarget can get my wife giggling about whatever we’re talking about.

There’s fun in life. People are often surprised in my clinic because I don’t distinguish between me as Ross and me as a doctor. There’s a lot of laughter; it’s a great relaxer and leveler. Over the years, patients poke fun at me, which I love.

Do I have time for hobbies? I don’t have pastimes — no time that needs passing. As my health changed, I decided there were things that I at least wanted to try. Typically, I would work, spend time with my two teenage daughters, exercise, and occasionally cook. Like all men, I think I deserve a medal when I cook because I don’t do it often.

I am very clean with dishes — that’s one of my stipulations. I try to instill that in my youngest daughter, who likes cooking with me: you have to tidy up as you go along.

My First Lung Cancer Symptoms

My mum, who was 90 at the time, came from Edinburgh to stay with us in 2022. As she improved, she insisted on returning to Edinburgh in May that same year. Around that time, I felt like I pulled something in my left shoulder after exercise, so I had a massage. The person said it was tight. It loosened up and then returned, but I didn’t think much about it. I thought I was just getting older.

Around the same time, I noticed that when I slept on my right side, my breathing sounded different. I was doing a two-phase exhale where there was a slight wheeze at the end. I wanted it to be asthma, but I kept wondering why it happened only on one side.

I tried my wife’s inhaler, which helped a bit, but I made an appointment with my primary care physician, who was a locum. He went down the asthma route, prescribed something, and said that if it didn’t work, we’d do something else. I said, “By the way, I’m a thoracic oncologist. Could we just do a chest X-ray?” He complied and I had the X-ray right away.

Scan Results

Saturday brought a PET scan and Sunday an MRI of the brain. The cancer had spread, with deposits in my brain, including the brainstem. The brainstem is only about an inch-and-a-half across, and I had a deposit about an inch wide — not compatible with life, yet there I was looking at it.

Monday, I had a bronchoscopy and a biopsy, performed by a friend; another friend, a pathologist, was present to confirm sampling. I didn’t pull favors; they just did this. From the chest X-ray on Friday morning to Tuesday morning, I knew I had a specific mutation, metastatic cancer, and the right treatment as an expert in the field.

Sometimes, when a patient passes, their family gives me unopened bottles of pills, which help others start therapy. Weeks before, I’d gotten just such pills from a patient’s family, which were the ones I needed, so by Tuesday afternoon, I started them. Later, I called the patient’s husband, saying his wife would be pleased we used her pills to start someone on therapy early — I didn’t say that it was me.

Reconciling Being Both Doctor and Patient

People say, “This shouldn’t happen to anyone, but especially not to you,” but I don’t think anyone deserves cancer more or less than I do. If anything, I know about it, so I can probably deal with it better. I think of it as taking one for the team. Less than a week in, part of my brain saw it as a privilege — a full circle moment of working on something and then literally walking in the shoes of my patients. I wasn’t angry.

In the first weeks, I’d lose control and sob uncontrollably, mainly thinking about my girls and the possibility of not having a role in their future. Dads are supposed to do certain things with their daughters. The feeling of leaving them vulnerable was hard.

Another thing that made me cry — and took longer to process — was when anyone was being nice to me. I kept the diagnosis close, but people reached out, and it’s hard to deal with others’ anxiety. I’m dealing with my own stuff; I don’t have time for yours. But you also have to accept kindness and love — not just give lip service, but actually absorb it, which is surprisingly hard.

The Girls’ Experience and Second-Line Treatment

The girls coped well. We didn’t burden them with every scan and bump. I’m a believer in minimizing cancer cell diversity — evolution needs diversity, so you want to minimize the palette. Even though the pill worked, I consolidated with chemotherapy, then radiation to all known disease sites, similar to what I would do for my own patients. Fatigue made me sleep more. The girls were fine and got used to finding me asleep on the sofa.

Maintaining Privacy During Treatment

For the first 2 1/2 years, privacy was easy. I only told my family, some close friends, and my medical team. I run the program. The surgeons didn’t need to know, but the radiation oncologists and pathologists knew.

When I told the team, I was a mess, but ended with three bullet points: treat me the same — if you were horrible, keep being horrible; keep the circle of trust — patients don’t need to panic; look after yourselves — it’s a shock for you, too. That worked until I had the bad reaction to the treatment, so I skipped conferences and kept the Zoom camera off as I felt so bad, like death with vomiting and constipation. I didn’t want my life to end this way or any public declaration to bring value. When I felt better in September 2025, three years after the diagnosis, I came out of the cancer closet.

I checked with the girls at a family meeting for their awareness. Beforehand, the counselor wasn’t sure the youngest had internalized what my diagnosis meant because she was 10 at the time. The counselor wanted black-and-white: Daddy is going to die from his lung cancer. During our family meeting, I used that line and everyone cried. Then, as teenagers do, they said, “What’s for dinner now?” Normality resumed, at least outwardly.

What Patient Advocacy Means: Perspective Shift

People want this Hollywood story: a terrible physician becomes nice because of cancer. I don’t think I was ever that bad. One ongoing mission is how we report side effects — grading is imprecise, missing duration. I tracked my own activities, like email replies during chemotherapy. They dropped to zero for two or three days after treatment and then returned, a visual representation of real impact for others. That’s how I see the value — showing actual patient function, not theoretical toxicity.

I benefited from my own work — how we surveil people in therapy, watch the brain, and consolidate with radiation. I was even involved in the initial trials for the drug that I’m on. I also benefited from research by my colleagues and patients who came before.

How I Live Life Differently Now

Now, I turn down things I don’t want to do. I no longer feel I must be a good citizen and join boring committees. I carve out time to try new things with the 90-day challenge by trying something new between scans. Yesterday, I did my first knitting class. I was terrible at it, but it was a new experience. Mentoring, encouraging, sharing mistakes and successes, that’s my legacy; I’m passionate about that.