LESSONS IN LIVING
A day in the adult infusion center at UC Davis Cancer
Nurse Anne Beatie checks in on retired engineer Frank Tate, a lung cancer patient, and his wife Pamela.
The young Eastern European woman, her frail frame wrapped in a bulky blue sweater, shuffles into
the infusion center, gripping her husband's bent arm for support. She speaks no English. Her fear is palpable.
Nurse Ester Molina greets her and steers her to one of the 19 adult infusion chairs at UC Davis Cancer
Center. Molina gives the patient a pillow for her head and blanket for her legs. Her husband takes a seat
at her side.
Forty-nine people will receive treatment in the infusion center today, several for the first time. But
this young woman's arrival is cause for quiet excitement among the infusion staff. Diagnosed with lymphoma,
the frightened patient has cancelled every appointment and refused all treatment, until now.
"If this goes well," charge nurse Gale Gibson says at the morning meeting, "she may decide
to consent to treatment."
Of the nearly 3,000 new patients who are seen at UC Davis Cancer Center each year, many will pass through
the infusion center. Chemotherapy drugs are administered here, and blood transfusions are given. Here
patients receive care for their pumps, ports and PIC lines technologies that improve delivery of
anti-cancer drugs and enable patients to spend less time at the cancer center. Patients also learn how
to take medications at home, how to cope with side effects and when to call the doctor.
Infusion center nurses are a special breed, versed in the latest chemotherapy drugs, equipped to recognize
and handle allergic reactions and other medical emergencies, and skilled at managing such side effects
as nausea and fatigue. They are also gifted vein-finders, humorists and listeners.
Over the course of the day the nurses will carefully review patients' lab test results to make sure each
patient is strong enough for treatment. If a patient's liver function is too compromised or a blood count
is too low, treatment may be postponed.
readies an infusion bag.
The nurses will check and double-check the name of each drug against the name of each patient, ensuring
no one gets the wrong medication. They will give patients anti-nausea medications, timed for optimal effectiveness,
and observe patients for adverse reactions. They'll offer crackers and bring juice. Between patients,
they'll disinfect infusion stations, change pillowcases, fold laundry and stock supplies.
Sense of humor
Fear may be common here, but so are laughter, grace and courage. "When they walk through the door
here for the first time, a lot of people are just terrified," Gibson says. "So we try to keep
it light, keep a sense of humor. The people who work here are really good at that."
At one infusion station, nurse Marlene Perkins is swapping wisecracks with John Hauck, a retired trucker.
The West Sacramento man is here for an infusion of mitoxantrone, a treatment for prostate cancer. The
chemotherapy solution, flowing slowly from a bag over his head to a vein in his arm, is Popsicle blue.
"When you leave here," quips Perkins, who has worked at the Cancer Center for more than 30 years,
"you're going to feel like a giant Smurf." A conversation ensues about the Smurf cartoon show.
Later in the day, Jennifer Ducray-Morrill, former deputy treasurer of California, comes to her appointment
bearing gag gifts for the nurses yellow and pink bunny rabbit watches, finds from a trip to the
Dollar Store. Gibson and Perkins gather to admire the gifts, but talk quickly turns to the upcoming wedding
of Ducray-Morrill's brother. Despite her illness, she intends to host the reception in her Land Park home.
She thinks she can make room in the foyer for dancing.
To keep her colon cancer at bay, Ducray-Morrill spends four consecutive days here every other week. It's
a regimen she may need to remain on indefinitely. "I certainly wouldn't choose this," she says.
"But the staff couldn't be better. They keep everyone and themselves cheerful. Nobody
is ever down. I don't know how they do it. They help you make the best of a bad situation. And I appreciate
it so much."
Other patients express similar sentiments. "I know this sounds funny," says Nancy Spain, an
administrative assistant in the ophthalmology department at UC Davis Medical Center, "but I never
want to leave here. I don't know how to explain it. This is a safe haven."
Spain arrived at 8 a.m. and won't be released until 1:30 p.m. For five and a half hours, she will be
tethered to a humming, beeping pump that will deliver a fixed rate and volume of taxol, a breast cancer
treatment, into her bloodstream via the port implanted in her chest. Yet Spain feels so at home here,
where everyone has cancer, that she spends the day with her hat off, bald head bare. "They are so
great here," Spain says. "They hold your hand, all along this path."
The admiration is mutual. "You spend the best time you can with the patients while they're here,"
says Robert Araiza, a nine-year veteran. "And they show you how to live. A lot of cancer patients
don't sweat the small stuff. They focus on what's important to them, their friends and family and
they remind me that I don't really have that many problems."
Joanie McCreary, a 46-year-old mother of two, arrives for
her infusion armed with knitting, a portable CD player, earphones and a book. Her colon cancer diagnosis
last year was a tough shock, but she says it now seems like a blessing. Her faith is stronger than ever,
she says, and she feels grateful for every day. "I used to complain about all the traffic in Folsom
when I'd drive my kids around to all their lessons and activities," she says. "Now I like sitting
in traffic because I can sit in traffic."
Along with gratitude, generosity infuses this center. At the reception counter is a large basket with
a hand-lettered sign: "Caps for chemo patients. Please take one." Volunteers sew and donate
the hats. Next to the hat basket is a candy jar filled with peppermints. Nurses keep the jar stocked using
proceeds from the juice cans they save and recycle.
The gifts from patients to their nurses are ubiquitous: A bag of sugar-coated chick peas in the pantry,
a giant tin of Almond Roca in the lunchroom, plants and thank you cards everywhere.
Patients also give to each other: They bring in their magazines, from Harpers and The New Yorker
to Teen People and Star, hundreds in all. Last year a patient and her husband donated an
ultrasound machine that makes it easier for nurses to find veins. One personal DVD player has been donated
to the infusion center, with eight DVD movies. The nurses are seeking donations of 18 more mini DVD players,
so that even when the center is full, every patient can watch a movie.
By mid-afternoon, five patients have pushed back their recliners, footrests up, and are asleep under
their blue blankets. The lights in two of the infusion stations have been dimmed. The patient in station
9 is snoring softly behind a drawn curtain. If not for the IV poles and needles, it might pass for an
airplane cabin on an overnight flight.
The Eastern European woman has been asleep for most of her transfusion. Her husband hasn't left her side.
Molina arrives to unhook her from the infusion pump, smile and say goodbye. The patient walks out, on
her husband's arm. They both look relieved. She keeps an appointment with her doctor the following week,
and begins chemotherapy the week after that.
"It's a rewarding job," says Chris Sharkey, a nurse who has also worked in hospice, home health
and management settings. At 3:30 p.m., she finally has time to fit in a half-hour lunch break. Infusions
are scheduled from 8 a.m. to 4 p.m. Monday through Friday. Infusion center nurses work four 10-hour days
a week, from 7:30 a.m. to 6 p.m. each day, except when a treatment runs late.
"Sometimes it can be sad," Sharkey says, "but we have the opportunity to help people,
wherever they are in their journey. And that's always rewarding."