It was June 2014. I was 30 years old, and I received a call from my doctor's office to say my test results were in. So I walked up to see her in my lunch break, and my doctor said she was very sorry to tell me that I had breast cancer. I didn't want to believe her and at first, I didn't. You see, I'm a lawyer and I needed some evidence. So I'm very embarrassed to tell you all that I stood up and I walked around to where she was sitting so that I could look over her shoulder and verify what was written on the page in front of her.
Malignant carcinoma. But still not wanting to believe it, I said, "Now, malignant carcinoma, you're sure that means cancer?"
She told me she was sure. Back at work, I handed over the urgent things that needed to be done while I was having more tests to see if my cancer had spread. But at that moment, work wasn't my priority. I was thinking about how I was going to tell my family and friends that I had cancer. How I was going to answer their questions about how bad it was and whether I was going to be OK, when I didn't know that myself. I was wondering if my partner and I would ever have an opportunity to start a family. And I was figuring out how I was going to tell my mother, who had herself had breast cancer when she was pregnant with me. She would know how I was feeling and have an idea of what lay ahead for me. But I also didn't want her to have to relive her cancer experience.
What I didn't appreciate at the time was that work was about to play a huge role in my treatment and recovery. That it would be my coworkers and my job that would make me feel valuable and human at times when I would have otherwise felt like a statistic. That it would be my job that would give me routine and stability when I was dealing with so many difficult personal decisions and so much uncertainty. Like, what sort of breast reconstruction I was going to have. And at a time like that, you would think that I would turn to my family and friends for support. And yes, of course I did that. But it would ultimately be my colleagues who would play a huge role in my day-to-day life. And they would be the ones to make me laugh.
You see, we were a pretty close team, and we shared a couple of really good in-jokes, like this time they overheard someone ask me how I got my hair so shiny and perfect — without knowing that it was, of course, a wig, and you know, it was a very good wig and it did make getting ready in the mornings very easy.
But in little moments like this, I appreciated what their support meant, and I wondered what I would have done without that network. I've spoken with so many people, women in particular, who haven't had the chance to have that network because they haven't been given the opportunity to work through treatment. And there are several reasons for this. But I think it mostly comes down to overly paternalistic employers.
These employers want you to go away and focus on yourself. And come back when you're better. And they use those kinds of phrases. And while these responses are well-meaning, knowing the benefits it brought me, it makes me incredibly frustrated when people are told that they couldn’t or shouldn't work, when it's something that they want to do and physically can do.
So I started to look into what an employer is required to do when someone presents with a cancer diagnosis. I discovered that under Australian law, cancer is considered a disability. So if you are unable to perform your usual work duties, your employer is obligated by the Disability Discrimination Act to make reasonable adjustments to your working arrangements, so that you can continue to work. What would reasonable adjustments look like for me? I knew the obvious impacts my diagnosis was going to have on work. Medical appointments would be scheduled during business hours, and I knew that I would need time off to recover from surgical procedures. Again, being a typical lawyer, I had done my due diligence on what to expect from treatment. Admittedly, a lot of that was through Doctor Google, perhaps not my best move and I wouldn't recommend that.
But while I was ready for all the physical side effects, what really scared me was this thing called chemo brain.
Chemo brain presents itself through memory loss, an inability to concentrate and an inability to solve problems. And if this happened to me, I wondered how I was going to do my job as a lawyer. Would I be forced to leave work? And how could I possibly have a discussion with my manager about reasonable adjustments to my working arrangements when I didn't know how I was going to be impacted? I was fortunate to have a supportive manager who was happy to see how things went as we went along, rather than requiring a concrete plan up front. I was lucky that while he may not have even known about this concept of reasonable adjustments, to him, it was just common sense.
But I've learned that it's not common sense to everyone. Everyone going through treatment will learn how it impacts them and what their limitations are. And they'll learn to adjust for that. So for me, there were the tips and tricks that I learned about the treatment itself, like, before you go to chemo, you need to make sure you're really well hydrated and that you're warm, because it helps the nurses to find your veins. And make sure that you don't eat any of your favorite food, either before or after chemo, because you're going to be throwing that up and you won't ever want to look at it again.
I learned that one the hard way. And then there were the tricks for managing my workflow. I scheduled chemo for first thing on a Monday morning. I knew that from the time I left the cancer care unit, I had about four hours before this fog screen would come down and I would start to be sick. So I would use that time to clean my inbox and make any urgent calls. The worst of the sickness would be gone within about 48 hours. And then I would log back into work from home. This treatment continued and I knew what to expect. I was able to set reasonable expectations with my business partners about what I could do and the time frames that I could do it in.
But I still remember the hesitation in their voices when it came to asking for things. And asking me to do things by a certain time. And trust me, these were people that were not afraid of setting a good deadline.
I got the impression they didn't want to put any extra pressure on me while I was going through treatment. And while I appreciated the sentiment, I actually needed the deadlines. To me, that was something within my control and something that could stay in my control when there were so many things that couldn't.
And as I was working from home, I was thinking about how employers should be applying this concept of reasonable adjustments in our current age, where one in two Australian men and women will be diagnosed with cancer by the age of 85. So, as we continue to work longer and longer into older age, the chances of having a serious illness while we're in the workforce are increasing. And with technology enabling us to work anywhere, any time, reasonable adjustments are no longer contingent upon whether or not you can continue to physically make it into the physical office. Reasonable adjustments are also not about just offering a longer break or a comfier chair to sit in, although those things might be good, too. At the very least, we need to be applying the flexibility policies and strategies we've developed for other scenarios, like for people with family responsibilities.
But how can we ensure that people are even having a conversation about what reasonable adjustments might look like for them if a manager's first response is to say, "Oh no, don't come back to work until you're better." And a light went on for me. It must be compulsory for managers to have to have these conversations with their employees. And lessons from people like me, that have really benefited from working through treatment, need to be more widely shared.
And I thought about what could be done to guide these conversations, and then an amazing colleague of mine, Camilla Gunn, developed a "Working with Cancer" toolkit. The toolkit provides a framework for those diagnosed, their managers, their carers and their coworkers to have conversations about cancer and the work support available. Camilla and I have now been to other organizations to talk about the toolkit and how it can help to guide through what, quite frankly, are otherwise some pretty awkward conversations. And I'm pleased to say that the uptake of the toolkit is increasing.
So what should be a manager's first response when somebody says that they're sick and they don't know how it's going to impact their work? It must be this: "To the extent that you are able, and want to, we would love to work out an arrangement for you to continue to work through treatment." We need to start positively engaging people with serious illness to keep them in the workforce, rather than paternalistically pushing them away.
I've told you my story because I want you to know the benefits that working through treatment brought me. And I also want to change your perceptions if you think that somebody going through treatment is just bored, frail and vomiting a lot. And yes, these things were true some of the time, if not a lot of the time, but I was also determined to push myself at work as much as I had always done. And I was able to do that because my employer gave me the choice.
Most importantly, I'm telling you because while it's a seemingly obvious choice to give someone, it's not one that is always offered or encouraged. And it must be.