Nikhil Joshi, M.D.
Doctor, Author, Leader
Nikhil Joshi is a young physician, writer, and speaker. He is passionate about furthering his ability to touch the lives of people positively.

Nikhil- F off

Nikhil- F off

I have to start this entry off by saying thank you everyone so very much. I’ve been pretty overwhelmed the last couple of days- it seems like the CBC thing has gone viral, and I’ve just received so much attention and love and it’s a bit crazy for me. And I’m hearing lots of peoples’ stories these days, and I just want to tell everyone who is struggling now, whatever that struggle may be, that I support and feel for you equally. I really hope all your shit works out for you today. I’ll take the love and support because it’s pretty nourishing. Anyways below is the story of my trip to Halifax which happened yesterday- happy Wednesday.

‘I hate this part’ I think to myself as we go through airport security. It’s Ungodly early, Mom and I are heading for Halifax today. I take off my shoes, belt, watch, and empty my pockets. Full of receipts from various restaurants I shouldn’t have been eating at, credit cards, health cards, and an unused condom still in the wrapper. As if an amazing woman is going to jump out of nowhere and totally want to bone a cancer patient. I laugh. I’m very capable of amusing myself.

I get through security okay- but then they stop Mom. They always stop Mom. Every airport across the world, Mom always gets pulled aside. And for some reason I’m just so fucking pissed off with that today. I’m about to say something when Mom waves me off. I go and sit down.

All around me in the airport people are coughing their lungs out. I remember the days when I used to be oblivious to people coughing. Now it’s a terrifying noise. I keep a surgical mask with me, but I don’t want to put it on while I’m waiting at the gate and have people look at me like I’m a fucking Pariah. I just wish the guy two seats next to me would just stop hacking away. I change seats irritably and go sit further away. “Man I’m in a really shitty mood” I think to myself. “Oh cheer up champ” a bright cartoon like voice says in my head. I then imagine a darker version of myself finding that bright optimistic voice and shanking him in the corner of my mind. I smile sardonically. It’s 6:05 AM. F my life.

We get on the plane and people continue to cough. “Fuck this” I think. I put on my eye mask, my noise cancelling headphones and my surgical mask. If I can’t see or hear people they aren’t real. My nose and face get so warm from my breath. But at least I stop freaking out about people coughing in the plane. I pass out and we land in Halifax. Why am I in Halifax you may be asking? I need a PET scan. (Positron emission t- what the fuck does the T stand for? Screw it I’m going to google it…. Tomography. The T stands for tomography) Anyways this scan will show whether or not the chemotherapy’s been working. And yeah at this stage I’m really hoping the chemo’s been working. Otherwise I’ve been taking a shit kicking for nothing. Which in abstraction would be kind of funny, but given the fact that’s it’s pretty awful, would not amuse me in the slightest.

I look at my Mom and we share a smile together. We’ve talked more and more as my treatment nears an end about where we’re going to go on vacation when this is over. Mom more than anyone deserves a vacation. We really have to get the fuck out of dodge once this over. I casually wonder if there’s a magic number of drinks that will cause a black out sufficient to forget that I had cancer and worried about dying incessantly. I however feel that the subsequent hangover would resemble a chemo hole too much, so I resolve to have just enough. Sometimes I close my eyes and go to the beach in the Corona commercials. I feel the warm sun on my face and a cold beer in my hand while listening to the endless ocean. Escapism much?

The cab takes us from the airport to the hospital. We proceed to the PET department and start our wait. I’m starving. I haven’t eaten in 14 hours. “You miserable little wretch” I say to myself “how many people are hungry in the world today?” I don’t know the exact number- probably a billion? Hmm maybe I am being a bit of a melodramatic ass, I think to myself. I really want to feel grateful, I’m trying to feel grateful but for some reason, I just can’t. The suffering of others does little to reduce my own as my stomach continues to grumble.

The PET techs take me in- and they’re the best part of the trip. I find them to be kind and professional. We laugh and joke and they put an IV into me. I was kind of hoping we could use the PICC line in my arm, but for some reason we can’t. Poke. And then they inject me with a radioactive dye and keep me in a contained room. Where’s a spider when you need one? I think I used that joke before. Whatever- still funny.

They eventually lead me into the room with the machine. It’s huge. I lie down and the whole thing starts. I’m not claustrophobic so that helps. I also have an eye mask on and I’m pretending to be asleep on Corona beach. I’m trying to not think about whether the scan will light up or not. (Not would be good). If the cancer hasn’t responded I’m going to need radiation. I’m not really a fan of that option as radiation has more and worse side effects than chemotherapy. But then again I guess I’m lucky to have access to any type of treatment that will save my life. I mean I could have been born into another part of the world and been totally poor and screwed. How many kids with Hodgkin’s lymphoma in Bangladesh are getting a PET? Not zero, but you know, pretty close I’m guessing. I’m not sure whether this is a mature perspective or just my attempt to make myself feel better about what is a rather shitty situation. I had a girlfriend once who hated that whenever she’d complain about something I felt was trivial I’d rationalize it like this. You didn’t do well on a test? That sucks, but everything will be okay and it could be worse I’d say. Maybe I was being an asshole…or maybe we all get too upset over stupid shit that doesn’t really matter. Time will tell I guess.

The scan is over, I thank everyone and then go to the restaurant Il Mercato (now called La Frasca). The food is crazy amazing. The waitress is so unbelievably nice to Mom and I. But I’m still in a kind of shitty mood. Finally Mom has had enough “Nik, what’s your problem today?!” she asks. “I just feel like I’m supposed to be thankful for all this stuff, but I just can’t. When you have cancer, you’re supposed to be grateful. I’m supposed to be grateful for the treatment, and for people helping me because I’m sick like I’m some kind of fucking charity case (Mom’s eyes narrow as I curse). And you know what? I hate that I’m not grateful. I hate that I feel like such a piece of shit. I know I’m lucky. I…I just don’t know why I’m like this.”

“Maybe you should stop trying to feel grateful, and just be. Gratefulness is not supposed to be manufactured, it’s supposed to genuinely arise because you feel for whatever reason that you are lucky or blessed” Mom offers.

I’m about to disagree with her because I always disagree with her, and never listen because I’m an ornery little shit these days, when the waitress comes over with dessert. “I just wanted to bring you guys dessert on the house” says the waitress “because you two were so happy and pleasant to serve” she says with a winning smile.

Her single act, an apple strudel with caramel gelato moves me so deeply I almost fucking weep in the restaurant.

It is amazing, and we take the bill and tip her generously.

Suddenly it all makes sense- and now I can’t help feeling that no matter the results I actually am truly fortunate, that even with cancer I’m still a Canadian and able to have access to amazing medicine and diagnostics, and being a doctor on top of it I’m an active (perhaps too active) participant in my own situation. You know what? I’m not going to bitch about airport security anymore. As Louie CK said on Conan “Did you just experience the miracle of flight?”. Yeah I did. And even with all the shit leveled against me- I’m still incredibly blessed.

Have a great day

P.S. For all those new to the blog it’s usually updated every Wednesday and Friday. For stuff on Monday check out and look for the Dr. C radio show.

6 Responses to “Nikhil- F off”

  1. Carol Ann Ryan

    You certainly have a way with words. Despite what you’re going through….I can still see your sense of humor coming through. Hang in there.

  2. Kris Osmond

    Hi Dr. Joshi,

    I’m touched and thankful for you sharing your personal experience with the world. People need to hear these stories. Patients need to know they’re not alone, and other’s need to know that it could happen to anyone and it’s our job to do what we can to help people in these situations. Your struggle is one I am all too familiar with and would like to do what I can to help.

    I work for the Leukemia and Lymphoma Society of Canada at the Atlantic Canadian office in Halifax. If you would be willing to contact me I would love the opportunity to speak with you and discuss your experience since your diagnosis and see how we as a group can be of assistance to you and our family. We have a wealth of resources and information available to you and think that your particular experience is one worth sharing.

    Here is the contact information for myself and the office. We would greatly appreciate hearing from you especially while you are in Halifax.

    1660 Hollis St. Suite HS2

    I wish nothing but the best for you and your family and hope you are able to make a quick recovery.

    With love and hope, Kris.

  3. B.

    I know just what you’re going through. 27 is really young for this but, as I’m sure you’re aware, some people are lucky enough to get cancer much younger. In my case it was much older, but I’m still barely a senior and my diagnosis came as an awful shock. With a lot of help from my shrink, my family, my doctors, my blog, some good meds, and 5 years of meditation life is looking a lot better. Somehow you just have to find your way through it.

    In the words of the great Red Green: “We’re all in this together!” Good luck.

    PS The people at QE II are really good, in my experience.

  4. Pat Rodgers

    You have to have grumpy days. It’s hard when you are an positive happy person to feel that way but it happens to the best of people!!

  5. Sheri Noseworthy

    I think you are doing amazing. I am one of the nurses that has met you through work. No offense, but I used to call you ‘Lil Joshi’…only because I would get confused as I also had taken care of your father’s patients.
    I just wanted you to know that I sincerely hope you do well. Keep your sense of humor,sometimes it is the only thing that may keep you going. Life lesson: I have learned more from being a patient than I think nursing school ever taught me. Nursing school taught skills and knowledge – being a patient, having pain, taught me true compassion and to really listen to people and not just hear them. Take care!

  6. Denise Thibeault

    Dr. Joshi, Nikhil ~ Came upon your blog quite by accident, but so very glad for that accident. Eleven years ago diagnosed with a stage 3 cancer. Frightening, maddening, and transformative. I fought like I never fought before through the surgeries and chemo. Through the long nights filled with fear and the innumberable days in the chemo room, the diagnostic imaging rooms and the bloodwork labs. Worse was the endless weeks and months in my very own ‘aloneness’. Just want to say I wish I had had your blog to keep me company during my cancer experience. Good luck. Don’t let this damnable disease get you. Best wishes. Denise.

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