I wasn’t crying while the doctor was surgically removing the worst-infected of my fingernails at each of our follow-up visits. Nail toxicities, as doctors call them, turned out to be a painful (and common) side effect of one of the most toxic of the chemotherapy drugs which I’d started before the first excruciating symptoms kicked in. (Thanks, Docetaxel!) As cancer drug research published in the Journal of the American Academy of Dermatology concluded:
“In recent decades, cancer mortality rates have declined due to development of systemic drugs targeting specific cancer pathways. Nail toxicities associated with these therapies are under-recognized by many, and contribute significantly to patient morbidity.“
Translation: Chemotherapy cancer drugs like Docetaxel – which affect every cell in our bodies – are very effective at killing off fast-growing cancer cells, but can also damage our fast-growing healthy cells, too – like fingernails/toenails, skin cells, blood-forming cells in our bone marrow, hair follicles, cells lining the mouth, digestive tract and reproductive organs – and the most disturbing reality is that our doctors won’t necessarily know how to help ease these “under-recognized” brutal side effects.
The journal paper also suggested this remedy:
“Frozen gloves or socks have demonstrated efficacy in reducing nail toxicities, especially those associated with taxane therapies like Docetaxel.” Taxanes are chemotherapy drugs that are widely used in cancer treatment since the 1980s. Researchers estimate that over 60 per cent of breast cancer patients treated with taxanes will develop “clinically significant” nail toxicities. Oh, joy! As if that wasn’t quite enough trauma, I also developed (among many other side effects) the Docetaxel-induced side effect called Hand and Foot Syndrome (HFS). Dutch researchers described Hand and Foot Syndrome like this in their 2020 study published in the medical journal called Oncology Reviews:
“Although HFS is not life-threatening, it can cause significant discomfort and impairment of function, and may seriously impact quality of life.“
SERIOUSLY IMPACT QUALITY OF LIFE!? No kidding!!
My experience of this painful chemotherapy-induced side effect included raw blisters that cracked open on the soles of both feet while large pieces of thickening skin were falling off both heels in chunks. That’s when my oncologist’s office arranged a walker on loan from the Red Cross just so I’d be able to move about – a walker I am still using to this day. So YES, I’d agree with the Dutch researchers that this side effect can “seriously impact one’s quality of life”!
But no, not even that drama explained why I was crying at the Urgent Care Clinic.
I was crying because that wonderful doctor was so kind to me.
Ever since I was diagnosed with invasive ductal carcinoma one year ago, I have met many, many physicians and nurses in the hospital and in the Cancer Clinic – but I have never ever encountered a physician or nurse who was so kind, so compassionate, and so PRESENT until that first night at the Urgent Care Clinic. My family described that wonderful doctor like this: “He should be teaching bedside manners to every med student in every medical school!”
Kindness should NOT be what makes patients cry.
It can however cause spontaneous weeping when we’re surprised by unexpected kindness – which tells a lot about the rarity of simple acts of kindness experienced in health care. Kind words, gestures or just simple courtesies offered to overwhelmed patients mean so much, yet cost so little. If that remarkable doc at the Urgent Care Clinic could be that kind, that compassionate and that PRESENT during those dreadful surgical procedures, why can’t every doctor and nurse (particularly those engaged in less dreadful tasks) do the same – or more?
Those creepy-sounding nail surgeries were done under local anaesthetic, which involved careful pre-surgery injections of freezing up and down each finger in question, one finger at a time. I was also prescribed a month’s worth of antibiotics to address the painful chemotherapy-induced pseudomonas bacterial infections that were attacking each nail bed, causing foul-smelling pus to seep out of each fingertip. (I know, I know – disgustingly gross!) I wondered at the time: “How much worse could I possibly feel?”
My oncologist had warned me about this specific chemo-induced side effect more than once early on after my breast cancer diagnosis: “Your nails will turn black, they will fall off, and it will be painful.” But in my case, my fingernails didn’t exactly fall off. They rotted off.
I could not have even imagined how excruciating the pain of infected nails turned out to be.
And those “frozen gloves or socks” touted to prevent nail toxicities?
As a breast cancer patient for whom stuffing my bare hands into painful “ice mitts” every three weeks for one long hour during each chemotherapy appointment had become routine, I can assure you that my now-deformed fingernails (i.e. the ones that have not yet been surgically removed) were NOT protected at all by those one-hour frozen mitt procedures. I still developed the “nail toxicities” despite hours in the Chemo Room wearing brutally cold ice mitts. These apparently work for some cancer patients – but for others, they just mean more pain.
My grown son Ben, who had rushed me to that Urgent Care Clinic the first night, and who stayed right beside me throughout the whole appointment was very brave, I thought (given how he tends toward squeamishness when things start getting bloody). Yet he still insists on referring to our Urgent Care Clinic appointments as “Mum getting her fingernails pulled out with pliers.”
By now, my toenails are next in line to exhibit signs of damage caused by Docetaxel chemotherapy – starting with the entire nail on my right big toe actually snapping off when I accidentally stubbed that toe against a wooden table leg – the toenail still looking freakishly “normal” (just a small amount of blood!) when I retrieved it from the carpet – complete with the original pearlescent pink nail polish from my last pedicure – almost as if it’s “normal” to have nails snap off near the cuticles. That is NOT normal at all, no matter how disinterested your oncologist is in your nails.
I used to feel embarrassed about crying in front of other people, especially physicians. But now, I’ve become a world-class crier whenever crying is the only reasonable thing to do. There are types of suffering in which crying should be considered compulsory. Why would we feel the need to try so hard to force back tears just so others won’t feel uncomfortable?
In fact, I highly recommend crying if you’re getting your nails pulled out.
♥ ♥ ♥
NOTE FROM CAROLYN: I wrote more about becoming a patient (no matter the diagnosis!) in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop ( please support your independent booksellers) or order it online (paperback, hardcover or e-book) at Amazon– or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Heart Sisters 
Your story makes me want to weep.
Crying in the presence of such compassion is not just cathartic but an opportunity for everyone present to realize that this space of healing can be holy ground, especially when doctors open their hearts to the reality of their patients’ profound suffering. Kindness in such difficult times should not be the exception but the foundation for all interactions.
I am sorry that you are enduring such debilitating torture (isn’t painful removal of nails a torturer’s claim-to-fame torturing method?). I had no idea that chemotherapy can lead to this outcome, and it makes me even more in awe of and concerned for you and other cancer patients who undergo such perilous and excruciating treatment. I envisioned side effects like nausea, hair loss, and so forth–all unpleasant to be sure–but not the torment inflicted upon you by the chemical agents that are supposed to save your life.
It’s hard to imagine trying to type a blog using fingers that must hurt with every movement, so your effort to continue to reach out to all of us is an act of courage and compassion. Surely you do so in order to inform and inspire your readers. Well, this reader is not going to keep procrastinating regarding scheduling a breast MRI, ordered last year when pain in one breast occurred. It comes and goes. Probably not breast cancer, I tell myself convincingly. I am way too busy to have breast cancer. Ha. My mother had a mastectomy at age 37, then promptly became pregnant with her sixth (and last) child one month after surgery. I have dense breasts, but I am 36 years past her age of 37, so I figured maybe any possible inherited tendency would be a moot point by now. But your story is nudging me out of complacency, and I am sure I am not the only Heart Sisters reader who will be inspired to take action to address breast health.
I (selfishly) do hope you can continue to write your blog, but only if it doesn’t increase your pain or adversely affect your health. You are a superb writer, a witty truth-teller, and truly a sister of the heart for those of us fortunate enough to have found your compelling blog.
Thank you, Carolyn!
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Hello Marie – thank you for your kind words. I love your observation that “Kindness in such difficult times should not be the exception but the foundation for all interactions.” I’m going to go embroider that on a pillow. . .
I too was way too busy to have breast cancer, which has impacted every hour of every day since I was diagnosed one year ago.
My first thought during the initial discussion of surgically removing my infected nails was just what you mentioned: isn’t pulling out fingernails what Korean prisoners-of-war suffered? The surgery itself was not painful, but it was oddly the THOUGHT of what was happening that made my brain explode. Luckily this amazing and kind physician at the Urgent Care Clinic talked me off the ledge with his remarkable approach and compassion.
You are reading my mind when you mention the “torment inflicted upon you by the chemical agents that are supposed to save your life” That is the impossible issue here: Chemotherapy is a barbaric practice, stopping just short of killing the patient while trying to kill off the evil cancer cells. I suspect that one day oncologists will go to their annual conferences and say things to each other like “Remember the brutal ways we used to treat breast cancer back in 2025? This WILL happen some day – but meanwhile, oncologists must LISTEN to their patients when we tell them we’re suffering – and then figure out what to DO about those side effects.
What we need (hello cancer research donors!) are treatments that target ONLY the evil cancer cells. Patients cannot continue to be the unpaid study participants who suffer real life torture while our healthy fast-growing cells are being happily destroyed. So far I’ve experienced a long list of Docetaxel-induced side effects that are basically ignored throughout the medical profession, or dismissed as “symptoms will go away once the chemotherapy is done”. That is simply NOT TRUE. Mayo Clinic oncologists recently reported on what they are calling “later effects” – chemo-induced problems that don’t show up after the 1st or 2nd Chemo Day – but months or YEARS later – and which cannot be treated.
Marie, thanks for mentioning “trying to type a blog using fingers that must hurt with every movement” Very insightful reality! I’ve figured out a weird system of rolled up towels around my wrists and fingers that allow me to type – with lots of breaks. I don’t know if this will be my final Heart Sisters blog post or not – the infuriating WordPress “block editing” updates make it essentially impossible for me. I’m actually surprised that when I hit the PUBLISH tab, it actually worked this time. Meanwhile, all 900 of my articles from 2009 on are (luckily) still accessible and free on this site – so lots to read for brand new readers and old-timers alike.
Thanks so much – take care. . . ❤️
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Oh that does sound truly miserable! Yuck, the chemo is so so hard. And yes I have been so touched by a physician’s kindness I sobbed all the way home. A chance appointment for follow up with the skilled plastic surgeon who has reconstructed my face 3 times after skin cancer surgery.
I was also weighing whether to have MOHS (cancer surgery which involves cutting away thin layers of skin) or radiation for yet another skin cancer on my nose. And getting radiation to a 2nd breast cancer. And dealing with an arrhythmia. He listened to my decision questions, told me the risk/benefit of both. Then looked at me with compassion and said, ”I’ve seen you through a lot and never seen you so worn down. Don’t do the surgery, radiation is sufficient.”
I felt seen in a way that is unusual in health care. This was theee years ago. No cancer recurrence in my ancient boobs, one less extensive MOHS and 3 years past surgery that corrected the arrhythmia. The old car still runs!
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Oh, Sara. I could cry just reading about what you have endured. It was all too much. What leaped out at me about your description of that kind physician was that this was a “chance follow-up appointment”. It wasn’t a longtime doc who knew you, yet you felt seen, heard and understood. What a gift that is for patients! And why aren’t ALL PATIENTS able to receive that gift?
Your chance meeting amplifies how patients can be treated with kindness and compassion even by a physician who is a stranger. Patients often express a preference for seeing their “own” doctor – but sometimes the fresh eyes of a new doctor can see what others have missed. I too had a completely random physician at that Urgent Care Clinic, a stranger who also wanted to know what my oncologist had prescribed for my painful chemo-induced neuropathy. I felt actually embarrassed for my longtime oncologist when I had to answer: “Nothing”. So this random physician explained some commonly prescribed treatment options himself. On the way home, with a new prescription, I wondered why this Clinic doctor was being proactive in trying to ease my symptoms, while my oncologist was not.
Sara, I’m so relieved that your “old car is still running!” I wish you many happy years of recovery and peace. ❤️
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Dear Carolyn,
what terrible pains you have to bear. I am so sorry for you. I have never heard of such side efects after chemo therapy. You must be a very strong person.
In the hospital they usually do not like crying patients. After my triple bypass 1983 I was sent to rehabilitation. Having been there one week (I should stay there 6 weeks) I got yellow eyes (hepatitis C from the blood transfusion) and was brought into the nearest hospital, where they wanted to keep me in an isolation room for several weeks. After one week, I cried to get to a hospital near our home. The doctor of the ward did not want to do that. To my luck, the doctor was changed after a week. He accepted my demand. It was the only situation where I have cried in the hospital.
But I must cry, too, if a nurse or doctor is kind to me. It is so seldom.
All the best for you.
Mirjami
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Hello Mirjami – so nice to see your name again in my Comments file! You have had so many hospital experiences by now! I’m glad that first doctor was changed!
Thanks for sharing your story. After all you had gone through in the nearest hospital – hepatitis C, isolation, the doctor’s refusal to transfer you to a hospital closer to home – you certainly deserved lots of kindness. There may have been overwhelming reasons to deny your options – but in my opinion, many hospital staff tend to say NO long before they even think of saying YES.
I believe that whenever possible, healthcare professionals should ask themselves this question about each patient:
“Do I want this patient to feel comfortable, or do I want this patient to feel UNcomfortable?”
That simple question could help to provide the patient-centred care that hospital executives always boast about during fundraising campaigns!
I hope you and your precious heart are doing well. Take care. . .❤️
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Carolyn,
I’m sorry that you are suffering so much through cancer treatment. There seems to be an unlimited amount of suffering involved with aging. Happy to hear that you had a caring, empathetic doctor as that can have such a positive impact on how one deals with things psychologically.
Sandy S.
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Hello Sandy – you are so right: meeting that caring empathetic doctor at the Urgent Care Clinic helped immensely to restore my faith and trust in the medical profession – ironically while I was comparing his communication skills to many of the doctors and nurses I’d already encountered. Some were great, of course, but I was stunned by the behaviour of so many others. I had started to believe that ALL doctors these days are dismissive or uncaring – which I know now is not true because I have personal evidence of that one amazing person. One of my Nuclear Medicine Heart Scan techs excused the rudeness of her colleague’s dismissive communication with me by saying “Oh, maybe he was having a bad day?” It’s easier for her to dismiss my story than his. I responded to her: “Do you know who’s having a bad day? HIS PATIENTS!”
Thanks for your perspective on positive impacts in medicine. . . ❤️
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Oh Honey, cry away! You deserve a little release after all this crap. It sounds like you’re handling the horror a lot better than many would. The family support sounds stellar too. Delighted to have the emailed blog back.
Thank you for doing it in the midst of all this.
Now go and have a good cry!
Big cyber hug…
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Good morning Deborah – thanks so much for your kind words. This emailed blog today might be my last – I found it mostly finished in my ‘draft’ folder and decided to see if WordPress (my blog host that has “updated” its editing feature in a way that’s impossible to navigate now) would allow me to publish this. It seems to have allowed half of the post. . I may be starting a new blog that isn’t WordPress this summer. Stay tuned… Arrrrgh. I hope you are doing well and enjoying this spring weather!❤️
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Dear Carolyn,
I am so sad to hear about these terrible side effects you are suffering. And so sorry that an act of kindness made you cry, the world must seem so unfair right now.
Go ahead and cry as much as you want to, and good for you.
I practice crying therapy regularly 🙂 and then I can get up and put one foot in front of the other again.
I will keep you in my thoughts.
Lauren Williams
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Hello Lauren and thank you for reminding me that it’s good to practice crying regularly! Both in sadness and in joy!
I now cry for example all the way through every strings concert my 10-year-old granddaughter performs in with her school music program because I’m just so happy watching her play her violin! That may sound crazy but it never fails to somehow move me to tears.
Take care. . .❤️
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Oh, Carolyn! I’m so sorry you have to go through that. You deserve all the comfort you can get, be it from crying, hugs, or chocolate.
Wishing all these passes soon.
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Hello Margarita and thanks for your kindness. I’m looking forward to hugs, chocolate and yes, crying when it’s the only thing left to do!
hugs to you,
Carolyn ❤️
PS – To my Heart Sisters readers: Learn more about Margarita’s amazing heart transplant story, described in poetry here.
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