ASCO Connection

July 2017

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ASCOconnection.org is a forum for the exchange of views on topical issues in the field of oncology. The views expressed in the blogs, com- ments, and forums belong to the authors. They do not necessarily reflect the views or positions of the American Society of Clinical Oncology. Merry Jennifer Markham, MD, FACP University of Florida @DrMarkham Refl ecting With Gratitude on Gifts From My Patients …There is a sheet of lined paper lying on my desk with three phrases written on it in black ballpoint. The paper reads: Lillian Boxfish Takes a Walk, Americanah, A Gentleman in Moscow. These are the latest book recom- mendations given to me by one of my patients, Alice*, a retired teacher in her 60s who is living bravely with metastatic ovarian cancer. Over the few years that I've known her, we've discovered our mutual love of books. At the completion of the medical part of each of our vis- its —the discussion of her symptoms, scan results, treat- ment decisions—we talk books. She tells me what she's reading, and I share what I'm reading. At some point in the last year or so, we've taken to calling this part of the visit "oncology book club." As much as I adore getting new book recommendations, I cherish these conversa- tions with Alice more. Several years ago, I walked into an exam room and noticed that my patient, Linda*, was knitting a shawl, the knitting needles clicking in her fingers as she worked to finish a row before packing the half-finished shawl and her skein of yarn back into a large tote bag. Linda was in her 70s and had ovarian cancer that was refractory to chemotherapy. Quality of life was of utmost importance to her, and she had opted for a purely palliative approach. We met regularly to discuss her symptoms and ensure she was thriving in her last months. As she neared the end of her life, she worked diligently to finish knitting the various shawls and hats and blankets she'd started, I'm sure with plans to leave these soft, colorful memories to the family members she would leave behind. I recall asking her about her knitting during one of those visits, and she assured me that if she could do it, I could. Over the next few months, I taught myself to knit using a combination of videos from Craftsy and YouTube. To this day, when I pick up my knitting needles and a skein of yarn, I think of this gift that Linda gave me, unknowingly. I have many patients who love to travel, as do I, and our conversations often head in that direction toward the end of our visits. Recently, one of these patients, Glen- da*, a woman in her early 60s who is in remission and in long-term follow-up for her cancer, pulled out a giant, overstuffed scrapbook from her trip to Alaska several years ago. "I know you're going to Alaska this summer, so I want you to write some things down," she said. "Get a piece of paper." Dutifully —and gratefully—I pulled out my pen and tore off a piece of paper towel to write on. She spent the next 15 minutes telling me her best tips and tricks for navigating Alaska by car, including must-visit stops along the route we'll be taking. The most important gift my patients have given me, however, has been the opportunity to be a part of their lives, to be let into their world and to share a part of their cancer experience with them. It's such a profound experience, being the oncologist for a patient with cancer and guiding them through treatment decisions, delighting in their joy when remission is achieved or when scans look promising, helping to ease the transi- tion to end-of-life care, or just simply listening when that's the only thing to be done. I am grateful to each of my patients for allowing me in and for placing trust in me. So many of my patients have impacted my life and helped to shape the oncologist I've become. To these patients, for this gift, I say thank you. *Patient names have been changed to protect privacy. Find full post online at ASCOconnection.org. PHOTO BY JESSE S. JONES ASCOconnection.org I 17

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