H&L Have you always lived in Toronto?
Marla I was born and raised in Montreal, graduated and completed two years of residency at McGill Medical School. I moved to Toronto for my post-graduate Masters, fellowship and specialty training at the University of Toronto.
H&L Is that where you met your husband Bobby?
Marla We knew one another from Montreal but not from university. I had finished first year Medical school and he had just graduated from Engineering in Philadelphia, we went out on one blind date and that was that. Three years later we met again at a party and started dating shortly after. For a year and a half he commuted from Montreal to Toronto then finally said, “No more.” He gave me an ultimatum on the steps of an escalator at the Dorval Airport. He said, “I’m not coming down unless you agree to marry me!” I said, “Come down and we’ll talk.” He said, “No!” “Okay!” I said, “I’ll marry you. Now come down.”
H&L That’s a pretty original proposal.
Marla Yes it was. In fact, we’ve just celebrated our 25th anniversary.
H&L Congratulations! You’ve been busy lately – an anniversary, your daughter’s graduation, speaking engagements, a book release. All on top of daily life – three children, husband, doctor, practice, CanadaAM - how do you balance it all?
Marla You have to read my book. It’s called Life in the Balance. It’s not only about life in the balance in terms of cancer and being given a significant message - maybe you’re not going to be around as long as you’d like, a real meeting with mortality. It became an opportunity for me to recognize I needed to look at my life. Much of my life has been defined by what I do. Who I am had become interchangeable with what I did. That was taken away when I couldn’t work in my office. Chemotherapy diminished my white blood cell count and rendered me susceptible to infection. The last thing you want to do is be in a doctor’s waiting room, never mind be the doctor. There was a huge void. There’s a chapter in the book, ‘Dr. Marla meet Marla’. I had never taken the time to learn who I was outside of what I did. Even ‘Balance TV’ was what I did in the office but to a much larger audience – medicine is a collaboration in education between the doctor and the patient. All of a sudden I had oodles of time. This was an opportunity to take some time to figure out some things. It’s not a surprise I wanted to do the documentary or write a book because it was the best collaboration in education.
H&L Was your intention to educate from the perspective of a doctor with breast cancer?
Marla As I began to write the book I realized this really wasn’t about the science and the medicine. It was about life in the balance. When I was first given the diagnosis my reaction was, “Oh my God, my life is out of balance. I have to make the right choices to survive. How am I going to live my life in balance?” This became more apparent when I saw the raw footage of the documentary. My eldest daughter said, “Breast cancer was the best thing to happen to my relationship with my mother.” It made me cry because it said, “What was it like before?” Her honesty and the impact stated maybe there were times my emotional commitments and time commitments were not the same. My kids said, “My mother has always been there for us, but not always physically” That blew me away (with tears in her eyes and her voice breaking).
H&L I can see it still does.
Marla It still does. And I am really, really grateful to have the lesson now as opposed to 20 years from now.
H&L And the lesson - in five words?
Marla The lesson is one word - mindfulness.
H&L Mindfulness in…
Marla Everything. One of the things you learn is a life in balance is not a formula. It is constant. Every minute is a life in balance. Mindfulness is the only way I can tell you what changed for me. I am far more mindful about what I say “yes” to, and what I say “no” to. Learning how to not feel like I have to meet everybody’s expectations. I didn’t want to disappoint anybody - my husband, children, friends or patients.
H&L You’re a ‘giver’.
Marla It’s been hard for me to learn how to be a ‘taker’. It was clear when I was doing the documentary I felt I had to do this on my own. It was called, ‘Run your own race’. As I felt I had to run my own race until half way through when I realized this journey should never be taken alone. My friends and family made sure I learned this lesson. They absolutely refused to leave me alone. They said “No!” to me. They showed me it’s just as much a gift to let someone give you support as it is for someone to take support. For the first part they were observers because I didn’t let them in. I even insisted on going to my first chemo treatment alone. How selfish was that? I asked my daughter to drop me off and everything would be fine - it was no big deal. The nurses knew better and scolded me, “This is not the way it’s going to be. You’re not to come alone next time. We won’t take you.” Halfway through chemo my girlfriend Susan showed up - very trepidatious. “I know you want to do this alone but I was in the neighbourhood.” Yeah – right. She chose not to hear my “No”. Chemo did start off fine but you know what? It stunk. Every single minute, stunk! Yet I felt like I had to make it easy for everybody. That was stupid and selfish.
I believe I’m the luckiest person in the world… Was I lucky life gave me breast cancer? A lot of people would say not. But it became a chance for me to do something with it.
H&L Has your experience changed you as a doctor?
Marla I’m pretty much the same as a doctor. Breast cancer hasn’t defined who I’ve become; it’s refined who I am in every way. I don’t think of myself in terms of breast cancer. I think about who I’ve become and how I’ve changed. That’s what I want to remember. I have to remember, it’s not yet a part of me. It’s hard to let the ‘old girl’ go, she’s with me 99% of the time.
H&L In the documentary you comment on how your son Matt asked the most realistic questions.
Marla He was uncensored. Adults censor their questions so as not to offend. Matt was 9 years old so whatever came into his head came out his mouth. Sometimes it was brutal.
H&L Would you share an example?
Marla One of things that affected Matt the most was when I lost my hair. He knew it was going to happen and asked why, but I had no clear answer. He watched me cut it in stages; the ‘G.I. Jane’ cut was cool. But the day I came home from the hospital bald was tough. I had on a baseball cap. Matt looked at the floor and said, “Don’t take off your hat, you’re scaring me.” I lost it. I went to my room and shut the door. I was hysterical. I stayed away from him. That left quite an impression because he knew he made me sad.
The first time one of his friends came over unexpectedly I was sitting in the kitchen, no hat, no wig. After we exchanged hellos I realized my state. I put on my cap. I apologized to Matt later for not having something on my head. He said, “No big deal.” Morgan had said to Matt, “Oh your Mom has cancer. My aunt has cancer and looks just like your Mom.” That was it; it was resolved.
H&L What do you love doing with your family now?
Marla I love to be with them. I love to go to lunch with my daughters Jenna and Amanda. We get manicures, shop, or just sit and yak about what’s going on in their lives. Matthew and I do things together. We love baking and grocery shopping. He says, “I knew how to eat cookies, now I know how to make them.”
H&L Has your relationship with Bobby changed?
Marla I think whatever we had taken for granted with each other has changed. You start your life together as a relationship, then it gets clouded with the lifestyle – the kids, their issues and schools; mortgages; family holidays; balancing work. It becomes about lifestyle unless you really work on the relationship. This experience reminded us our relationship is important. Now we spend time alone. We’re both mindful we can’t take anything or each other for granted.
H&L When did you know medicine was your calling?
Marla When I was old enough to think about what I wanted to do with my life. I love people. My mother’s a teacher and I’ve become an educator. My Dad wanted to be a medical doctor but because of ‘The Depression’, he went into optometry. My parents brought us up believing education was critical. They encouraged us to succeed and reach-for-the-top – if you love science and people, become a doctor. I never believed there was a reason why I couldn’t succeed.
H&L Would you like to do ‘Balance TV’ again?
Marla Differently. The more I did it the more ideas I would get about how I would evolve it. There’s nothing like this show in Canadian or US television. I was disappointed we weren’t renewed. It was a network business decision, not a personal decision. ‘Balance’ was an education for me. Learning to become a host was difficult. Figuring out how to get the right guests, ask the right questions, and give viewers useful information. ‘Balance’ was not just about medicine but ‘alternative’ medicine; how you eat and cook, exercise as well as children’s health. It was so broad and fun! My job was to challenge the best brains out there and debunk what’s science, what’s evidence, what’s not? Including ‘alternative’ or what I like to call ‘complementary’ health. I had the critical ears and asked the critical questions, not in a clinical or sarcastic way but in an educative way. People want to know. I want to know.
H&L What keeps you going through your extremely busy day?
Marla I believe I’m the luckiest person in the world. There’s a difference between luck and chance. Luck is what life gives you whether it’s good or bad. Chance is what you do with it. Was I lucky life gave me breast cancer? A lot of people would say not. But it became a chance for me to do something with it. I’m lucky that when I was young I decided to go into medicine. I get up in the morning excited. What an awesome responsibility that people trust me with their physical and emotional health. What a thrill after 25 years of practice people are still coming to me. Now I see the kids’ kids. I’m lucky I made a career choice where I can say every day, “I love what I do!”When my kids ask what they should be my response always is, be whatever you want to be, but be sure you want to be that person, don’t just find a job. Choose what’s going to make you excited about waking up in the morning. What you decide today doesn’t have to be forever. Be open to opportunities and experiences; realize if you change your mind it doesn’t represent a failure of what you did before. “Who do I want to be now?” is the question, not, “Who do I want to be tomorrow”.
H&L Great advice for everyone. What are your ‘must do’s’ every day?
Marla I must (she says emphatically) speak to my children every day, wherever they are. I must get a hug from Matthew even though we’re getting to the stage where it’s gross. Connecting with my children and husband are definite ‘musts’!
And, I must not fail to remember ‘now’ is what counts. I have to enjoy the ‘now’. I’ve raised my family and my patients to believe ‘what if’ is a waste of time.
Somewhere along the way you make a decision about what you’re going to do with what you get.
H&L What are Dr. Marla’s beauty secrets?
Marla Being happy and emotionally settled. In terms of practical tips: what and how I eat is important, and so is exercise. I schedule in exercise just as I schedule in patients, otherwise it would get pushed aside. I work with a trainer at least twice a week and I speed walk regularly - quickly.
H&L Is there anything you’d love to do that you haven’t done yet?
Marla I wish I could sing but it’s never going to happen (she chuckles). This is the area of: “If I really want it to happen I’ll make it happen.” It’s a waste of time to bemoan. There are lots of things I’d like to do but they’ll come to me as life goes on. My kids mention I live a life without regret. There are things I dread have happened, but I push forward.
H&L You constantly offer advice, what’s the message you like to leave with people?
Marla Now it’s, “You can make a difference in your life. Every day you can decide how to make a change. You can be less of a victim, no matter what your circumstances.” There are circumstances that make it difficult not to feel victimized, such as poverty and inequity; I’m not blind to that. It’s hard to argue with me because I’ve buried a six-month old child who died of SIDS and I’ve lived with chemotherapy. Life has given me challenges. It hasn’t been ‘a bed of roses’. I’ve had an opportunity to look at those circumstances as a doorway. It may not feel like it is a doorway of opportunity, but it is a doorway of action. Somewhere along the way you make a decision about what you’re going to do with what you get. You can be empowered to make a leap from having an attitude and putting it into behaviour and action. It’s hard to do; I find it hard to do. But you can. I don’t always make the right decisions, I don’t always do the right things but now I’m mindful about it. The book starts by sharing some bad decisions. But by being mindful I knew when and how to make the next decision. There will always be another decision. I promise. Just as there’s always another train coming into the station, there is another decision to be made.
Life in the Balance, My Journey with Breast Cancer published by HarperCollins Canada is in bookstores September 2006.