It is cancer.

I thought I remembered what it felt like to hear those words, and what those first, awful days after a cancer diagnosis are like.

Like all cancer survivors, I remember some of the specifics in excruciating detail: the date and time of day, the spot in the kitchen where I picked up the phone, the tone of the doctor’s voice, delivering the news as clearly and gently as she could. “It is cancer.” I thought I had held on to the most important part of that experience, for the most noble of reasons. Without a clear memory of where the journey began, I would not be able to fully appreciate the challenges and triumphs of this experience. I would need a clear memory of it all if I had any chance of comforting the saddest and shakiest of my patients, of convincing them that their anxiety and grief is not, as they so often fear, beyond that from which they can recover.

I was running errands Monday morning, on the way to the countertop place, frustrated with the latest delay in the bathroom renovation, when my cell phone rang. It was my very best friend, calling from her home in another city, the usual and frequent kind of calls that have sustained our friendship half a country apart. I was not expecting news of any kind, and I greeted her without a flicker of guardedness. I could hear her faintly crying before she spoke. “It is cancer,” she said tearfully, her northern accent making it sound like “kyenser”. Maybe that was why it took a minute for me to take in what she’d said.

Or maybe, when it is someone you love, the words just sound different.

I guess it is like childbirth: you somehow forget the worst of it, and despite the fact that I work in and with cancer every day, my mind had, mercifully, erased a lot. The visceral shock of life-changing news, out of the blue, on an ordinary Monday. The irreversible nature of the words: Take them back! Take them back! I wanted to shout, as if in some Jumanji-like spell, it was the speaking of them which would unleash the flood of inevitable events to follow. The fitful sleep, the awakening in the night in the moment right before you remember the words that were spoken. The devastating moment afterwards. The lack of appetite: for all food, most of the time, peppered by intermittent and irrational cravings for whatever tastes to you like comfort, and survival. The crying jags out of nowhere,  the pall that, for a day or a week, seems to hang over everything. The moments of panic replaced with cautious optimism. Worst of all, the waiting.

But enough about my week. She is coping beautifully.

I have heard it questioned many times, the comparison of being the cancer patient and the caregiver: the sister, the husband, the mom, the best girlfriend. It is an understandable question, I suppose, though pain is pain and grief is grief, and I don’t think differences between two kinds can be measured or compared, maybe not even described. There were times in my illness when I found my bald and chemotherapied self duct-taped together with adrenaline and steroids and prayers, oddly and unexplainably OK, and I wouldn’t have traded places with my friends and family for anything. This same best friend’s sobs on the phone years ago, the time that I called to relay my bad news, are among those clearly etched in my memory. It was clear on that day, and many others, that her pain and disappointment equaled—perhaps even exceeded—my own. Even in the years since, she has never been able to discuss it too much without dissolving into tears.

Now, however, facing her own diagnosis, she is taking it one step at a time. She does not dissolve, and she is far from inconsolable. As ever, she is whip-smart, clear-headed, optimistic. She is taking in all the information and becoming fluent in a new language. She is making informed and intelligent decisions. In short, she is doing a great job.

It is not important to me to know—or even to ask—if it is harder to be the patient or the friend. They are both hard, and we don’t get to choose of which to be. All that’s important to me now is to be there for my friend, and for my patients too.

And to always remember this truth: that when it is you, when it is your best friend or family member, nothing about cancer is routine. And those three little words—“It is cancer”—sound different.