Turning Points: Navigating Mental Health

Episode: “Unpacking the Trauma and Emotional Toll of Cancer” (S4E2)

Host: Frances Leese, Tufts Health Plan / Boston Globe Media
Guest: Dr. Beverly A. Zavaletta, Family Physician & Cancer Survivor
Date: September 25, 2024

Episode Overview

This episode explores the profound and often overlooked mental health impacts of a cancer diagnosis. Host Frances Leese is joined by Dr. Beverly A. Zavaletta—Harvard alum, family physician, and cancer survivor—for an honest conversation about coping with the psychological fallout of cancer, the importance of support systems, and strategies for healing the mind and spirit alongside the body. The episode provides insights for patients, caregivers, and anyone seeking to understand the intricate intersection of cancer and mental health.

Key Discussion Points & Insights

1. The Emotional Shock of Diagnosis

• Initial Reaction: Dr. Zavaletta recounts her vivid memory of receiving her cancer diagnosis at an end-of-school party, feeling instantly “stunned, paralyzed, like a chill coming over me.” ([03:21])

  Quote: “I just kind of barfed it out. And she took a second and she just said, ‘I’m here.’ And she scooped me up in her arms, she hugged me, pulled me into her.” — Dr. Zavaletta ([04:02])

• Host Reflection: The host emphasizes the sense of control lost and how overwhelming such news can be for anyone. ([05:19])

2. Life in the Aftermath: Priorities and Action

• Shift in Focus: Dr. Zavaletta describes how quickly priorities shift from everyday concerns to survival.

  “All the priorities that we normally have of work or family engagements, it just goes on the back burner... It’s like you are now in this race that is life or death.” ([05:40])

• Decision Overload: The pace of treatment decisions leaves little time for emotional processing initially. ([07:12])

3. Fear, Routine, and Lingering Challenges

• Core Fears: Her greatest fear was leaving her children motherless, a fear that overshadowed even fear for her own life. ([08:15])

• Isolation in Treatment: Immune suppression forced her into isolation, making her keenly aware of the psychological toll. ([09:05])

4. Coping Strategies: Asking for Help and Rejecting the “Battle” Metaphor

• Learning to Ask for Help: Dr. Zavaletta admits, “I have not been great at that... but something in me really said, ‘Hey, you gotta do it.’”

  “I made a really big effort to tell my circle of friends and my family pretty quickly and to really think of things and ask for help.” ([09:52])

• Rethinking the ‘Battle’ Metaphor:

  “In cancer, the battle metaphor is very common... I really didn’t like that. It was too violent.” ([10:28]) “I want to shift to a healing mindset, not a warrior or battle mindset.” ([11:22])

• Embracing Healing: While she occasionally used the battle mentality to psych herself up for chemo, Dr. Zavaletta strove to “visualize my body healing itself.”

  “I would try to visualize my immune system being in concert with the medication to kill the cancer... befriending my medicine.” ([12:47])

5. Balancing Strength and Vulnerability

• Host Reflection: The importance of “balancing strength with vulnerability,” emphasizing self-love and positive self-talk as critical for healing. ([14:00])

• Surrender and Acceptance: Dr. Zavaletta describes finding power in surrender:

  “It felt a little bit like surrender to the process, surrender to... trust and acceptance of reality as it is right now.” ([14:47])

6. Life After Treatment: The Long Shadow of Recurrence

• Ongoing Anxiety: The fear of cancer returning is “a rollercoaster.” She describes living life in bursts between follow-up tests, feeling like she just received “a lottery ticket for the next three or six months.” ([15:41])

  “The effect of that for me was to try to jam in a lot of the bucket list items.” ([16:28])

7. Advice for Patients and Supporters

• For Patients:

  “Find a safe person to talk to... don’t go down alone. The very thing you need to help you, which is your mind, is the thing that’s struggling... reach your hand out and hold onto someone else.” ([17:27])

• For Supporters:

  • Presence Over Perfection: “The best thing... is be present and continue to be present... Just that statement of presence, saying ‘I’m here,’ is the same thing as saying, ‘I’m not scared of whatever’s coming.’” ([18:46])
  • Practical Help: Dr. Zavaletta notes the cognitive overload patients feel, making decision-making nearly impossible. Practical support—meals, rides, chores—without expecting the patient to delegate can mean everything. ([19:41])

8. How Cancer Changed Dr. Zavaletta as a Physician

• Deepened Empathy: Her own illness profoundly impacted her relationships with patients.

  “If there are 10 levels of that [empathy], I was maybe on level four or five only... I gained a greater appreciation for assessing where people are and what do they want to engage with and what do they want to work on.” ([21:33])

• Creating Space: The sincerity and mental openness she now brings as a doctor help foster trust and healing. ([23:47])

9. Resources for Mental Health Support

• Mindfulness: Recommends Sounds True as a robust resource.
• Therapy: Suggests Acceptance and Commitment Therapy (ACT) as especially helpful for patients facing unchangeable hard truths.
• Finding Help: Psychology Today’s online therapist directory; cancer center in-house counseling for those in larger cities. For many, online therapy is the most accessible route. ([24:23])

Memorable Quotes & Moments

• “I want to heal. And so in that discussion with her, I really had a change of mindset and said, I want to shift to a healing mindset, not a warrior or battle mindset.” — Dr. Zavaletta ([11:22])
• “If the only thing that you can remember is this, it’s to reach out, like, reach your hand out and hold onto someone else.” — Dr. Zavaletta ([17:50])
• “Just that statement of presence, saying ‘I’m here,’ is the same thing as saying, ‘I’m not scared of whatever’s coming.’” — Dr. Zavaletta ([18:53])
• “The person who is sick is not capable of being the CEO of that situation.” — Dr. Zavaletta ([21:00])
• “You can find that place within you of love and of healing, whatever that is going to mean for you.” — Dr. Zavaletta ([27:00])

Important Timestamps

• Diagnosis Experience: 03:10–05:19
• Shifting Priorities and Early Fears: 05:40–07:12
• Isolation and Coping: 09:23–13:54
• Rethinking Metaphors & Healing Mindset: 09:52–14:24
• Fear of Recurrence and Living Fully: 15:22–17:09
• Advice for Patients and Supporters: 17:11–21:05
• Physician’s Changed Perspective: 21:16–23:47
• Mental Health Resources: 24:01–26:48
• Closing Hope Message: 27:00

Tone & Closing Message

The conversation is candid, nurturing, and non-sensational—balancing realism with hope. Both host and guest stress the importance of compassion, community, and accepting help. The show concludes with a unifying message:

"You are not alone and you can find that place within you of love and of healing, whatever that is going to mean for you... it’s there, it is within you and you can find it.” — Dr. Beverly A. Zavaletta ([27:00])

For further resources, visit globe.com/turningpoints.