On a regular basis, I try to read the New York Times Health and Wellness section. Earlier this week, Dana Jennings, a reporter for the newspaper and cancer survivor wrote a column that caused me to have an aha! moment. In my clinical practice with lymphoma and leukemia patients, one of the best days for me is on the 10th day post their final cycle of chemotherapy when they come to see me for their final assessment and nadir blood work. I feel deeply satisfied being able to tell patients that their chemotherapy treatment is over, they have responded as we hoped and we will arrange some follow up scans in the upcoming weeks/months and see them back in the clinic to review the results. For me it has always felt like the last day of school sending the kids away for summer vacation with the knowledge that what lies ahead will far exceed anything they've gone through in the past year. The patients however always look at me with great disbelief and say "You mean that's it?" As if I would joke with them about something so important. I don't think I ever really understood what this experience must be like for a patient. Dana Jenning's column has given me much needed insight into this transitional time for patients. Although his diagnosis and treatment differs from those in my practice this is one instance when we can make comparisons between cancer patient populations.
He calls this feeling 'post-treatment letdown' and I think it is an accurate description. We are all creatures of habit and after a cancer diagnosis disrupts the natural rhythm of life we search to find a new normal. For those on treatment, a new normal involves the rules and routines of treatment. He describes the process of coming for treatment as his 'job', a place where he knows everyone's name and has come to learn the idiosyncracies of the environment and cultures from the insider's view. The act of engaging in treatment is 'doing something' rather than the alternative of the uncertainty and the waiting. The end of treatment signals an important transition period for patients and their families. This column has reminded me that as a primary nurse I must pay more attention at ths time to help patients adapt to this new time in their lives.
You can check out Dana Jenning's blog at http://www.nytimes.com/2009/06/30/health/30case.html?_r=1
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