When is it ethical to tell someone something a bit disappointing? 

This question is keeping me up at night: “When is it ethical to tell someone something a bit disappointing? ” I would tell the person this news personally, yet I understand the precaution; don’t tell them because they are already going through a lot.

I finally got access to my patient portal and was excited to read my labs from the CT and bone scans. The bone scan was great; no cancer was detected in the bones. The CT scans showed nothing of concern in the liver, the lungs, or the pancreas—all unremarkable. That’s my favorite word right now: unremarkable. However, in a small line hidden, it reads: IMPRESSIONS: OVAL MASS IN LEFT BREAST 3.1 X 2.6 CM—SHOULD BE BIOPSIED IF NOT ALREADY.

FUCK. What do you mean?! Already? This test was after the surgery on Feb 4. Nothing was detected in Nov when I had my mammogram. How did this go under the radar? What does it mean? Do I have to get surgery to remove it after I am done with chemo? Does this mean I need to have radiation on both breasts? Was I right in thinking both of my breasts were ticking time bombs, and I should have done a double mastectomy (which, by the way, I suggested but was convinced otherwise due to the data the surgeon had was what we thought to be the most updated?)

My stomach is sick. This is a real-time talk-through with myself, trying not to spiral.

This isn’t that bad – this is the treatment for triple-negative breast cancer: chemo —> surgery. The chemo can help shrink the tumor. This can happen. I sure hope, though. I feel overwhelmed. I wish I had my friends who didn’t live out of state here so I could hug them. I wish my boyfriend was here so I could hug him. This is so scary, and I feel like such a wimp. It’s only day 3, and the stress of managing chemo has been insane plus this news?! Diabolical.

I messaged my concerns in the portal to the oncologist. I hope to get a response in the coming days.

I want to know, did they know? Did they elect not to tell me?

I could have handled it. Undoubtedly better than now, isolated in my room at almost 11 pm.

Despite the news, I had a pleasant day with manageable symptoms. Maybe I managed well enough because I had this upcoming news to contend with and sit silently. I’ll stop the stream of consciousness now and try to sleep now. But wow, what a bomb.