Writing the "Vitality Signs" column is part of my routine, and naturally offers me the opportunity to ponder and put forth reassuringly straightforward numbers. Statistical significances, clinically meaningful results. Each potentially offers insight, in some small way, about how the oncology community might ease the distress or minimize the suffering or sorrow of an individual or a family stricken by cancer.
It is the sort of task that psychologists like myself recommend to those in the aftermath of a tragedy such as the inexplicable shooting of 20 first-graders and their heroic protectors in a bucolic Connecticut town.
Grieve, yes. Pull your family close.
But do not spend hours watching network coverage, as minuscule facts or fallacies emerge, the latter to be discounted later in the interminable cycle of televised despair.
Minimize exposure to the event unless there is something tangible you can do.
Focus on your routine.
Concentrate on positive ways that can make a difference in your world.
I heard the heartbreaking news, as you likely did, in the middle of a busy workday filled with the day-to-day challenges, personal tragedies, and yes, small joys, that cancer leaves in its wake.
I noticed that my colleagues and coworkers spoke of the horror unfolding in hushed tones, behind closed doors, tears brimming. I later wondered if we were trying to protect some of our patients, even for a brief time, from having to hear of sadnesses beyond the ones they bravely faced that day. For others, perhaps celebrating a last day of chemotherapy or radiation treatment, we may have felt compelled to preserve their relief: Freezing in time a moment of silent peace in the village snow globe before the storm swirls once again.
Tragedy spares no one who works in the field of oncology.
It is a specialty infused by existential questions; why heartache touched this family, why so young, why so poor a prognosis or response.
Yet we have in common with each other, our patients – even feuding family members – a simple enemy, cancer. It’s the bad guy who rallies us in solidarity. When it wins, the ending at least is in accordance with life’s rhythm of beginnings and endings, birth followed by life and then a natural, if not always easy, death. Ideally, peace comes at last to the family, who may have been there to offer comfort, perhaps to a 6-year-old.
I spoke recently with a gifted pediatric hospice nurse who described moments of beauty, relief, and spiritual connection in such exquisitely painful bedside moments.
The memory of that conversation only deepens my sorrow about the 6-year-olds who died in horror at Sandy Hook Elementary School.
I’m sure that people ask you, not infrequently, how you could have chosen oncology as your specialty, when so many specialties would keep you far from the angst that is a part of that world. Of course, such questioners do not consider the joy of an unexpected remission; the deep connections reforged between family members once estranged; the bravery, grace, and abiding loyalty unfolding before us every day.
As the days have passed since the Connecticut tragedy, I hope you have been especially attuned to the indescribable beauty in the world of your chosen calling. I hope you are gratefully holding your family close. I hope you see clearly now the difference you make to the world in ways great and small.
Dr. Freed is a clinical psychologist in Santa Barbara, California, and a medical journalist. This column "Vitality Signs," appears regularly in The Oncology Report. Visit www.oncologyreport.com to see what is new in Vitality Signs.