Title: Inside Outside
Published by: University of Michigan Press
Release Date: September 11, 2006
Pages: 256
ISBN13: 978-0472115792
Buy the Book: AmazonBarnes & NobleIndieBound


Cancer. It’s a coarse, jagged word. Rough as the sound is, the meaning is even rougher. To physicians, cancer means malignancy—the out-of-control growth of cells. To patients, cancer means terror and lurching nose to nose with finality.

The treatment is brutal. As Susan Love, the distinguished and sometimes controversial breast cancer surgeon, describes—first they cut you, then they poison you, then they burn you, and you are grateful. And then there’s the psychological impact.

Losses, like dirty laundry, pile up quickly. The sense of wholeness and well-being is the first to go, and then identity—the life-long sense of who I am—unravels. Innocent fantasies of togetherness, the comfort of bodily integrity and the ability to ignore tough things fall away. Ultimately dignity, confidence, and hope vacillate and, in a terrible stroke of unkindness, hair disappears.

The medical system, advertised as giving care, dishes out hurtful brutalities in the name of cure or palliation. It seems unending. Seasons change. Winter melts into spring which blossoms into summer which fades into fall which then returns to winter—and the assaults continue. Until they end. Then it’s over and the sun shines again on a forgiving world.

This is the story of my journey… through cancer and beyond.


“Janet Gildsdorf, who is both physician and patient, writes brilliantly about both those roles as she deals with cancer.”
—Abraham Verghese, author of My Own Country and The Tennis Partner

“Janet Gildsorf recounts in vivid detail what happens when a woman physician faces breast cancer, from diagnosis to treatment and beyond. Told in a stream of consciousness style, Inside/Outside bears witness to Gilsdorf’s emotional and physical trials, her personal hurdles, and her increasing sense of self-discovery. This book offers a different perspective on the breast cancer journey.”
—Harmon J. Eyre, M.D., Chief Medical Officer, American Cancer Society

“Inside/Outside recounts the cancer journey of a physician/epidemiologist—as vivid and clinical as it is human, vulnerable, and inspiring. It will enrich both patient—and physician—readers.”
—Fitzhugh Mullan, M.D., The George Washington University, author of Vital Signs: A Young Doctor’s Struggle with Cancer


It was during the aftermath of my third chemo infusion—the nausea, the fatigue, the fuzzy thinking—that I began to reminisce about my medical school classmates. Lying in bed, I started that day’s entry in the journal I had kept of my experiences with breast cancer. I wrote about the strong bonds we medical colleagues share, the discipline of our training, the efficiency and beauty of our medical language, and the way we learned to accept hurting people as the first step in helping them through an illness. During my year of cancer, my medical colleagues would ask, “How are you doing?” and I would answer, “This sucks.” They understood completely.

About two pages into the journal entry, I realized it was getting longer than anticipated, so I crawled out of bed and hunted down a legal pad. I kept writing and writing. Then I began revising. The nausea, fatigue, and fuzzy thinking gradually faded (until the next chemo infusion) and I continued revising. Finally I discovered I had composed a personal essay, which I submitted to the “A Piece of My Mind” feature in JAMA, the journal of the American Medical Association. They accepted it right away.

Months later, I ran into a friend who said, “I enjoyed your piece in JAMA. Would you be interested in turning that essay into a memoir?” It took me two seconds to respond, “Sure, why not.” He was working with the University of Michigan Press on a book series focused on medical humanism and thought such a memoir would be an asset to the series. I wrote a book proposal (using an old one of his as a model, since I’d never even seen such a beast), UM Press accepted it, and I spent a year writing. Thus, Inside/Outside was born.


Today is Valentine's Day, a day for chocolate hearts and lacy greeting cards, and it begins like every other Monday. I hang my coat on the hook behind my office door and check my calendar: a search committee meeting and a medical education meeting, an interview with a new faculty candidate, a lecture to pediatric residents. In addition, I need to dictate a recommendation letter for a graduate student, return patient phone calls that will accumulate over the next ten hours, revise a scientific paper, and review the lab results from last week's clinic patients. Tony (the three-year-old with septic arthritis): has his sed rate normalized yet? Anna (the sixteen-year-old with a heart transplant and presumed aspergillus in a pulmonary nodule): has her lung tissue grown any fungi yet? Megan (the four-year-old with AIDS): has her CD4 (lymphocytes) count increased or her viral load decreased since we changed her medicines? Today promises to be ordinary, to be filled with the usual.

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