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The letter arrived in last Monday’s mail.

The return address was my oncologist’s office. I expected a bill, maybe a medical report, or perhaps a flyer about the upcoming 5K run that supports the cancer center and its patients.

What I never expected, or even imagined receiving, was a personal letter from my oncologist.

I didn’t have to skim the content to find the subject. It appeared in the first sentence, notifying me that she was returning to Iowa, where her family lives.

Iowa? Granted, geography has never been my strong suit, any more than math or science, but I was fairly certain that Iowa was too far to drive from Wyoming for my appointments.

She wrote how it had been an honor and privilege to care for people struggling with a cancer diagnosis. That’s when it hit me.

“She’s part of my inner circle,” I said, holding the letter. Tears blurred my vision. I slumped on the couch and did the only thing I knew to do – grieve.

Through therapy I was introduced to the concept of an inner circle. As it was explained to me, there are many different circles in my life, filled with myriad people. From my boss to my back alley neighbor, there are numerous individuals I interact with on a daily basis.

But only the closest people, those I trust implicitly, are part of my inner circle. Anyone outside this circle may have some influence on me, but their input and opinion aren’t what matters. They aren’t part of my circular tribe.

My inner circle isn’t very big. My therapist reminded me that’s OK, that everyone’s is different. I hadn’t realized until receiving the letter that my oncologist was part of my inner circle.

I also realized why. I took my time choosing her. I was selective and purposeful. I’ve rushed into relationships, even marriages, and I continually rush to react, but in that case I hadn’t. The new pattern started when I started dating my husband, Ron. We had a long courtship.

Ron proposed in December 2011, but we didn’t tie the knot until July 2013. I gave myself and my relationship with him the time it needed to develop. Ron is part of my inner circle. I trust him with my life, which is why he’s the helm of all my medical directives.

In choosing my oncologist, I took the same approach. Since my diagnosis last October with lobular carcinoma in situ, I’ve seen two oncologists for my cancer care. I allowed myself the opportunity to determine who I wanted to work with. LCIS has a five-year treatment plan. It’s a long-term relationship.

In June, when a mammogram detected two new calcifications in my right breast, my devastation was met with compassion, understanding and support. That’s when I knew who I would spend the next four years with. I never imagined she’d leave before my treatment finished.

The news was crushing. But that’s what happens when someone in our inner circle leaves, whether by circumstance or tragic misfortune: It is a tremendous loss. The only way to get through it is to feel it, which isn’t my first response.

When a situation happens that’s beyond my control, my emotions seem to double. I’ve often tried Scarlett O’Hara’s “I’ll think about it tomorrow” approach, but it usually doesn’t work. Neither does denial or hoping the letter was an early Halloween prank.

Since working with my counselor, I’ve learned that grief accompanies loss. There’s no way to sidestep the process, especially when someone in my inner circle is involved. It’s real, it’s sad and it sucks. But I wasn’t alone. I reached out to others in my inner tribe and found support.

Mary Billiter can be reached at


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