Sad for me

Friday. February 28, 2025. Day before yesterday a notification popped up that there was a new message in MyChart. I suspected Rugo’s assistant was reaching out to set a date for my next appointment following the upcoming March 18 chest CT scan. Instead the subject of the message was, “Farewell from Dr. Hope Rugo.” “What?” I thought, “That can’t be right!” Reading through tears Dr. Rugo shared that she was leaving UCSF. Retiring after 34 years. She was taking a new position as Director of Women’s Cancers and Breast Oncology at City of Hope including five centers in Southern California and nationally. Her last day would be April 16, 2025.

I felt like I’d been cold-cocked. It was a visceral reaction to unforeseen and devastating news. I just kept crying. I couldn’t help it. I still can’t.

I have been under Dr. Rugo’s care for more than six years. As with any long term relationship, it hasn’t always been easy. Over time we have learned how to not step too hard on one another’s feet as we dance through the complicated steps of my disease. Many times we’ve had different ideas on which way to go next. But through honest and meaningful discussions, we were able to reach a consensus we both felt good about. I always felt heard, and I’d like to believe she always felt listened to.

When my diagnosis graduated to Stage 4 Unresectable Metastatic Triple Negative Breast Cancer (MTNBC) in 2021 with few options for treatment, I knew surviving another 2 to 5 years was going to be a challenge. I also knew I was in the best hands possible under Dr. Rugo’s care. I envisioned that she would be with me every step of the way no matter the outcome. I believed that, other than Steve, she would be the first person to know if and when I decided to choose quality of life over the endless assault of treatment. I do know that I would likely not be sitting here today if it were not for her tirelessly and creatively coming up with new treatment options including the game changing MTNBC research study. However, I now know I took Dr. Rugo for granted.

My universe has shifted with the loss of Dr. Rugo as my oncologist. It’s off kilter. Like I’m taking a step back at what could be a critical time in my treatment. The loss of our shared history, the short-hand of our conversations, her understanding of the kind of support and approach that works best for me, my understanding of how to broach a subject with her, and most of all our mutual respect are all going to have to be learned anew with her replacement.

I suspect my last visit with her was my last visit, and soon I’ll learn the name of the oncologist to whom I’ve been assigned. As Dr. Rugo stated in her message, I expect that person will be “fabulous,” but not nearly as fabulous as Dr. Rugo, of course.

I’ll always be grateful for Dr. Rugo’s compassion, sensitivity, advocacy, curiosity, intensity, determination, selflessness, honesty and kindness. It was a gift from the universe to be her patient. To know she would always be in my corner.

I am sad to my core. I feel selfish for not wanting her to go, knowing she will be improving and saving the lives of countless others just as she did during her tenure at UCSF. I wish the knowing made it easier to say goodbye, to let go, but it doesn’t.

My appreciation for her impact on my life is inexpressible. I wholeheartedly hope for the best of the best for Dr. Hope Rugo. After all, hope is exactly what she gave me.

In the end, though, maybe we must all give up trying to pay back the people in this world who sustain our lives. In the end, maybe it’s wiser to surrender before the miraculous scope of human generosity and to just keep saying thank you, forever and sincerely, for as long as we have voices. —Elizabeth Gilbert