September 2017


At the Children’s Hospital

Rachel Schwartz

About the artist:

Rachel Schwartz currently work as a healthcare researcher at Lucile Packard Children’s Hospital Stanford, in Palo Alto, CA. “My work focuses on improving care delivery for patients and their families, particularly those with cultural or linguistic communication barriers. My PhD was in Communication Sciences and Disorders (from McGill University) and I completed a postdoctoral fellowship in delivery system science at the Palo Alto Medical Foundation Research Institute.”

About the artwork:

“Outside of Lucile Packard Children’s Hospital Stanford, I observed this crying bird of paradise. For me, it captured the feeling of working at a hospital, where beauty and grief coexist in nearly every encounter.”

Visuals editor:

Sara Kohrt

To Chemo or Not to Chemo

Twenty years ago this month, I was diagnosed with colon cancer.

Postsurgical analysis of my biopsies indicated that the cancer had grown just into my intestinal wall. Pathology said it was a genetically aggressive type, but no cancer cells were found in the lymph nodes that were removed along with much of my descending colon. In addition, no metastases were found during either surgical inspection or imaging. 

So, to proceed with chemotherapy or not? There was no evidence the cancer was loose in my body or already in my liver, but there could be no proof it wasn’t. And if it was, chemo might kill it.

Reflection in the Mirror

I love my bathroom–after all, I picked the flooring and all the finishes, including the mirror spanning the wall opposite the shower. One morning, I step out of the shower, drying my underarm, when a bump under my breast reflects in the mirror. When my arm is down, it’s gone. When my arm is up, it’s there. Is it a cyst? Did I hit my chest? Is it in my breast? Oh, well, I’m late to work, so I run off.

A Dreary Day

It was a dreary January Seattle afternoon. I’d lost my job helping my son, who’d suffered repeated outbursts of angst despite doctors, counselors and inpatient hospitalizations. 
I sat sipping tea across from Martin, my child crisis system advocate. Martin’s eyes seemed kind. We discussed my options. It became clear that the Child Study and Treatment Center (CSTC), Washington State’s inpatient child psychiatric facility, was the only viable residential choice. State programs meant mounds of paperwork and procedures. As I said, “Let’s get the process going,” Martin’s demeanor changed.

Providing Comfort, Providing Care

“It’s your patient. What would you like to do?” my attending asked. This question was not meant simply as a test of my knowledge; I was expected to give my opinion as a valued member of the team. A requirement for fourth-year medical students, my acting internship was more “intern” than “acting.” I worked alongside residents on the inpatient medicine service, calling consults, updating families and placing orders. There was one difference, however: all of my orders required an MD’s signature.

Buoyed by this safety net, I got a taste of the thrilling yet overwhelming influence physicians can have in the lives of their patients. Our everyday decisions regarding diagnostics, medications, and procedures can have profound consequences. In just a few years, I would have to make my own choices, without the safety net. I was and am aware that in some cases, the right decision could end up meaning the difference between life and death.

No Turning Back

My first chemo was a year ago today. It had been scheduled to start eight months earlier, when I was first diagnosed with breast cancer, but I chose a different path and had hoped to avoid chemo altogether. My oncologist had initially recommended four months of chemotherapy to shrink the tumor before surgery, but he also mentioned that I qualified for a clinical trial that would use a pill for six months to cut off its estrogen supply. 


Thomas Nguyen ~

Consider what remains: chipped yellow
            paint, roman candles, wilted gardenias,
so many photographs. Accept that

time makes things distant, that his
            absence doesn’t bleed into your memories
as much as it used to. Try harder and

harder to remember the last time
            you saw him, cords wrapped around
his legs like snakes, all white

and black, hidden underneath
            neatly-pressed khakis. And my melanomas,
he once showed you, with a smile.

A Painful Decision

I thought it would be easier than it was, but it was one of the hardest decisions I ever had to make. Ma had been declining mentally and physically for the previous several years. This once-feisty woman–who’d been able to add up her grocery bill to the penny in her head and work seven days a week at a local children’s store while still maintaining an eat-off-the-floor home–had become a shadow of herself. Ma barely ate, rarely wore anything but an old white t-shirt  and a pair of torn underwear, and sometimes at night wandered the halls of the apartment building where she and Dad lived.

Dad was worn out caring for Ma during the day and being on guard for her whereabouts and well-being at night. I, who lived two blocks away, was worn out by panicky phone calls from Dad that brought me to my parents’ home at all times of the day and night. It was obvious that Ma needed more care, that she required placement in a nursing facility. But making the decision to send her there was emotionally painful.

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