Pathographies of cancer illuminate what biomedical discourse overlooks. Minoritized scholars illustrate how bodies and knowledges at the margins are both cared for and silenced. As a gay academic who came of age during the AIDS epidemic and now lives with Stage 4 metastatic cancer, I write from oncology’s “dirty margins”: outside cure and within institutions where marginality has long shaped my labor and leadership. I examine how sexuality, pleasure, and ambiguous grieving intersect with advanced cancer, and how these embodied knowledges can queer and crip the clinic. By foregrounding erotic life, loss, and resilience in an autopathography, my narrative praises exemplary care while critiquing medicine’s discomfort with ambiguity. Methodologically, I draw on autobiographical reflection informed by queer theory, poststructuralist feminism, and crip theory to explore three sites: the erotic body as an archive of vitality and ambiguous loss; insider–outsider tensions across academy and clinic; and a shift from seeking positional authority to being—servant leadership and pedagogical legacy. In this minoritized pathography, I explore tensions between gratitude and critique as a generative queer gesture. Offering praise while unsettling biomedical silences queers the binary of “good” versus “bad” care. For biomedicine, this entails greater tolerance of ambiguity and integration of sexuality and grieving into care; for the humanities, recognition of embodied, erotic, minoritized knowledges as central to reimagining illness and work. Ultimately, such narratives transform suffering into meaning, legacy, and pedagogy—acts of queer resistance that teach how to live and die with authenticity and love.