A letter to the staff of the Western New York Cancer Care Center
Dear staff members,
Today is the last of my 45 treatments for prostate cancer. The Maker should have recalled these defective parts centuries ago but a successful class-action suit has yet to be achieved. One out of six males – one out of four on African American models.
Then there’s the design flaws. The main fluid draining conduit runs right through the middle of this walnut-shaped little part but integral to one of the higher orders of human experience. Location, location, location. If you get any swelling or irritation in this flawed part, you’re stuck with the ridiculous drama of having to know the location of every public drainage facility for miles around. Clearly Google and all of silicone valley partners should have resolved this problem by now.
The same should be said of breast cancer and those who blithely and casually dismiss the worthiness of 99% of the rest of humanity who don’t measure up, in their judgment, to their station in life. Didn’t society move beyond the 19th century classicism portrayed in PBS’s “Upstairs Downstairs?”
But you work at Cancer Care of Western New York and you are doing significant things to resolve these parts of the problems. You serve on a team of gifted individuals who are successfully battling cancer.
Now all of us are compensated for what we do in our careers. No matter where we go, they’ve got to pay us to work there. What is different about what you do is that you are called to be present in healing encounters. Those of us who come through your doors come with some brokenness. We are in transition, having learned that something in our bodies is in need of repair. Surgery, chemotherapy, radiation or a combination of them all.
We come into your office, as you well know, with a the waterfront of fears, unknowns, anxieties and sometimes depression being expressed by all the personality types of humanity.
The cancer, with which we’ve been diagnosed, lingers on like a giant outdoor billboard plopped down on our front yard. It says YOU HAVE CANCER! To our dismay, the giant billboard also appears in our living rooms, kitchens, certainly our restrooms, our cars and at work. CANCER no less. . . . Me, <em>for cripes sake</em>.
So your patients are jumping in and out of all of Kubler-Ross’ s stages of <em>On Death and Dying</em>. Denial, Anger, Bargaining, Depression and Acceptance. Regardless of our grasp on reality, everything is temporary. No matter how many years we’ve enjoyed the comfort of our personal lifestyle and all of its familiar coffee shops, dollar stores, local pubs, favorite shopping malls and TV shows, ‘we’re just a passin’ through.’ Everything changes.
As patients, we also carry into your office a real sense of loss. As we are jolted into realizing that we are in the ever-shortening last stage of our lifetimes, we sense that our lives are going to change. Our lives will never be the same as before.
What we all don’t immediately realize, after our biopsies, is that while you provide care and services for us, we become part of the Cancer Care of WNY team. The closer we follow the play book (the protocol advice of each module’s specialist), the smoother and more effective the results will be in bringing about our healing. But we’ve got to become team players ourselves.
In any spoken or printed words of what would help us, we are not quickly seeing all the work that has produced it. Unless we have benefitted from medical training, we don’t see the thousands of research and practice hours behind each aspect of treatment. We don’t know about the published and collegial-scrutinized research papers, the doctoral dissertations, the measured and evaluated clinical trials, the blind and double blind tests that thousands, before us, have undergone to determine the best courses of treatments. We don’t hear any of that but in a way, we trust that all of those things are behind everything we experience.
<strong>Trust.</strong> That’s something all of us patients cling to with a lot of motivation. Your white coats are actually not necessary. You’ve got 5 million dollar IMRT machines buzzing their merry way around our bodies like R2D2 on steroids. So we know your competence must precede your responsibilities amidst the mammoth financial investment in this life-sustaining infrastructure around you.
Hope is the holy grail of the healing process. Every one of us is looking for hooks on which to hang our hope for our futures.
By now, we know life will not be the same from this point on. Our frantic but unrealistic hope for lack of change always must yield to reality. “Life is what happens when you’re making other plans.” Reality always trumps and holds all winning cards. With whatever cards we hold, we optimistically call the other side of our transitions “the new normal.”
At Cancer Care of WNY, you are essentially working in a battle zone. You see a lot of suffering and pain. You see, on our faces, the fear, the pain, the depression. Sometimes the brokenness. You see some of us shuffling in and wonder how it is that we are still ambulatory. In nanoseconds, you can sadly see other eminent medical problems that will necessitate care in other clinics.
The other day, in the waiting area, an elderly woman was brought in for therapy in a wheelchair. Shortly after arriving, she began to cry. She was weeping from her unbearable pain. Whatever was the cause, the enormity of her internal pain could not remain silently contained in her frail body.
Fortunately, your staff colleagues rushed to her side and helped her into an examination room for immediate pain support.
Despite all the suffering you see in your patients, you stay focused and resilient. Your energy and fortitude in the midst of the suffering is remarkable. You are thoroughly professional and somehow you remain personable and caring.
But here is where you shine, not only here at the Cancer Care Center of WNY but on into your future.
Not only are your patients in the midst of transitions themselves, all of us experience transitions throughout life. You already have and will definitely undergo changes of your own. You’ll experience transitions in your relationships, in your careers. You’ll change your thinking on some of the things you once valued above all else. Some of the things you pursued will be left behind for other matters you will come to value as more important. As the old Simon and Garfunkel song said, “When I think back on all the crap I learned in high school, it’s a wonder I can think at all.”
As much as we like to embrace our seemingly unchanging world, it changes and we simply can’t control most of it. As do those of us who are patients, you, will go through transitions in your life.
Most of us already have migrated through changes, however old we may be. But when you think back through your transitions, you know there were some difficult ones. But who were the people who helped you most during those transitions?
Significant others. It was a friend or relative who was particularly present in your life when things got out of hand and were most scary. They listened to you when you made no sense. They stayed with you to help you get more information. They were there for you to take in and absorb your frustration, your denial, anger, bargaining, depression and ultimately your acceptance of the way things landed. They were “your person” as the Christina and Meredith characters portray in ABC’s <em>Grey’s Anatomy</em>.
As the same time, that’s not what your job is at work. You have a very medical, technical or clinical responsibility. Certainly the pain and uncertainty you witness on a daily basis causes you to sometimes leave work with your batteries totally drained. You’ve undoubtedly experienced burnout. You may have seriously wondered if there is another line of work that would call forth from you yet untapped yearnings and dreams without leaving you emotionally shredded and run through the wringer.
I was a Protestant minister for fifteen years. I loved the work. The teaching, the counseling, the writing and the many opportunities to be creative were at the center of my academic, intellectual and emotional career life for 60 to 80 hours a week. But I was burned out. I had to get away from the endless hours amidst funerals, crisis counseling and the usual petty skirmishes over which color to paint the lavatories or whether investments on the youth groups should triumph over architectural repairs.
One year, I changed careers. I went into marketing, advertising, writing, technology and videography.
At first, people were utterly shocked that I’d make such a change. Early on, though, I discovered nothing had changed in me. I found the obvious truth that customers (seeking my marketing or technological support) needed the same focus and caring as those who were once my parishioners. Obviously different contexts and delivery of services but the same focused listening and human caring is needed.
So how is that relevant to your truly brief daily interactions with those of us who are your patients?
It’s clear that your patient encounters are not lengthy sessions on helping us sort through the problems and hardships of our lives. Your job is to empower the therapy and to teach how how to make adjustments that support the therapeutic protocols for our healing.
Your presence in the tasks at hand is the same as how you and I relate to a neighbor when we’re handing them a poorly aimed newspaper. It is the same when we exchange a few words with our mail carrier or a clerk at the store. We’re looking them in the eye and relating to them in an unconditionally accepting and open way. We are taking them fully in, in the moment, however brief the exchange may be.
Your patient encounters all seem to transpire in brief moments. It’s not the duration of the exchange. <em>It’s about how present you are in those moments</em>, even though there are many moments and many of us patients who interact with you throughout the day.
It can, and should, become routine because of the limitations on time and the narrow focus of your work. But the magic ingredient in every one of your patient encounters is you.
The magic that is taking place is in your extending of yourself. Your non-verbal communication. Your tone. Your full presence in those moments, as short as they may be.
In each of these moments, you have been genuine and friendly. It’s when you are being kind and patient with the guy who feels woefully inadequate because he doesn’t think he’ll be able to retain the water he consumed in order to suspend his bladder up out of the way of the soon-to-be radiated prostate. It has been years since he was frantically waiving his hand in second grade to get the teacher’s permission to go to the rest room. The feelings are still the same.
In each of your patient encounter moments, you are being flexible and open for any question that might come your way. When you use your energy and focus beyond your job task to be responsive in these moments, <strong>you are being truly present in the moments</strong> in this transition period of your patients. You’re putting your personality and humanness into the mundane acts. That makes our experience here, with your team, transformative and healing.
The way you are responding in these moments makes us feel that we are not just in a drive-through medical center, ordering up a cancer cure to go.
Instead, we feel that we are fortunate to be a part of a greater team that is committed to our personal healing. It makes us feel more whole, even though the hand we were dealt is not optimal. You make us remember that however brief the moments we are with you, we are part of something that is much bigger and more embracing than the smaller concerns that are just contained in ourselves. You are making us feel, and reminding us always, that we are all intricately connected to and part of the wonderful human race. <strong>You are doing this with your presence</strong>.
That’s what I want to thank you for. For what you do, I am grateful. But for who you are and have been, in the 45 days of treatments, for your personal presence in this segment of this transition for me, <em>thank you</em>.
Cerish the abilities you possess and are using in this current career. They are embodied in in your DNA. And nobody, no transition, no circumstance, can ever take away from you the unique aspects of who you are.
Thank you for your presence. I’m sure that many others will feel the same gratitude from your presence in the years to come – wherever you choose to live and work. It is in being mindful of this sense of presence, that you possess, that you will find the meaning of your life. Cherish it.