[edited video transcript] On my twentieth birthday I was diagnosed with cancer and I spent weeks in intensive care while my doctors tried to halt the cancer’s galloping course through my body. I was devastated. I was just a child. I thought, “I can’t die now, I’m just starting!”

After I was well enough to go home, I began the daily trek back and forth to the hospital for months of radiation treatments followed by two years of chemotherapy. I was skinny. I was hairless, and I was noncompliant – that is, I didn’t follow my doctor’s orders.

Each time he gave me chemotherapy, my doctor would explain this whole complicated drug regimen: you take six pills now, three pills then and after lunch and so on. I didn’t do it. One day I might take all the pills; some days I would skip a few, and other days I’d take none. My doctor wanted me to stay home because my immune system was at low ebb and I was at great risk for infection. I’d go out dancing.

A few years later, I looked back at my behavior in awe. The millions of dollars of biomedical research that was distilled into the knowledge, experience, procedures and drugs aimed at a disease that was costing tens of thousands of dollars to treat, and it ultimately relied on the actions of a weak, skinny, scared 20-year-old to have its impact.

I had to show up. I had to take the drugs as scheduled. I had to avoid the risks or the whole thing wouldn’t work. I wasn’t a very good patient, but just good enough apparently. I know I’m here today, in part, because of the skills of my doctors and nurses and how they made use of the tools of medicine: the surgery and chemotherapy and radiation. But without my participation, those tools would not have made any difference.

Health care is a shared enterprise. My role in that enterprise has been brought home to me again and again through treatment for four additional cancer diagnoses, a dangerous heart condition and the ongoing care for the conditions that that many diagnoses and that much treatment demand.

I’m impressed with the health care that is now available to treat diseases that – even a decade ago – were a death sentence. And I’m so very grateful for them. But we and our doctors and nurses often overlook just how much the success of these tools depend on our active, informed participation. We have to show up. We have to stay on the diet. We have to take the pills. We have to avoid the risks. Or we don’t realize the benefits.

Original blog post by Jessie Gruman. Updated by the GW Cancer Institute June 2016.