Duke Cancer’s Spirit: A Day In Oncology
There is a man almost directly in front of me sleeping with a white blanket over him. He is recently partially bald, a side effect of life saving medication. Next to him is a woman with no hair. She wears a Nike Michael Jordan hat. Jordan extends his arm dunking a basketball in white silhouette on her black canvas hat. Her husband sits working on a HP laptop. He gets up to bring his sick wife water. She adjusts pillows supporting her back. A nurse bends over to clean her “port”. Ports are internal intravenous tubes, tubes drugs from silver polls flow into.
In front and to the right a beautiful lady wears a Zebra blouse with matching purse and a large translucent pearl necklace. Her hair is short either growing out or coming back. She holds a Television remote in her right hand next to her ear. There are TV’s at each chair angled down form the ceiling. She holds the remote next to her ear. Sound comes out of the remote. The lady in the Zebra blouse with matching purse leans to her right saying something to a woman unmistakably her mother. Her mother gestures with her right hand, shakes her head, speaks forcibly and turns her gaze toward her sick daughter.
Soon a new Duke Cancer hospital with an outdoor infusion center will open (January, 2012) increasing the number of daily chemotherapy patients from 15 to 170 (or more). Everything Duke’s Cancer Institute is exists in this room where people in need are being helped by angels. Any organization, business or tribe is only as good as its foot soldiers. Duke Cancer’s soldiers are the best.
Duke’s Oncology Treatment Center is a hive. Supervision in the treatment center exists, I’ve met the head of nursing, but touch is light and helpful. There isn’t much you need to teach many of these “pros from Dover” to quote M.A.S.H. (the movie not the TV show). Almost everyone in the room has more than passed Malcolm Gladwell’s
10,000 hours to “pro status” (Outliers).
Cancer doesn’t understand prejudice. Cancer doesn't differentiate by socio-economics. Everyone sitting next to a computerized poll with liquid gold flowing down long tubes has THEIR cancer. Cancer may be as unique as fingerprints, but treatment is best practices averaged out by types of cancer.
Duke’s Comprehensive Cancer Center, soon to be named the Duke Cancer Institute, will look to create targeted cancer treatment. “We need to treat to an n of 1,” Dr. Neil Spector explained at last week's inspirational Duke Board of Overseers meeting. An “n of 1” means Duke Cancer treats individuals with cancer not cancer the disease. Duke’s reorganization and rebranding is about what authors Don Tapscott and Anthony Williams call the “Wikization of Medicine” in their book MacroWikinomics
(highly recommended). Duke’s researchers and doctors have always been in the same room. Now collaboration is prized.
Grace is the word to describe Duke’s Oncology Treatment Center. "Grace comes hard for cancer patients" a patient explains. Cancer patients feel condemned to awkward silences, tension and pain. Duke Cancer’s spirit breaks cancer’s awful grip. Patients recover grace with expert care, care so sensitive and ingrained it is automatic providing a shelter from cancer’s storm.
Duke Cancer’s grace is expressed, constant and yet surprising. Last week I was surprised when Karen Cochran, Duke’s superb Director of Development, included me in the new Cancer Center’s “topping off” ceremony (picture to the left and me signing the last beam below). Watching the new cancer center's last metal beam float skyward with thousands of signatures was emotional, the symbolism unmistakable. We fly skyward even as skies darken; a brewing rainstorm made its presence felt soon after the beam was placed.
“Why is there a plant on one side of the beam and a slim cylinder on the other,” I remember thinking as beam lifted. Approaching thirty feet fireworks exploded out of plant and cylinder for a surprise explanation. Several hundred people jumped in surprise sure beam, plant and cylinder would come crashing down. Streamers rained down and collective fear turned to joyous laughter. Who doesn’t appreciate a good scare?
Duke Cancer creates community, support and transparency in hundreds of ways. Here are some of my favorites:
- Community bulletin boards Throughout the Duke Cancer and Duke University Hospital pictures of events, cancer patients and families cluster on bulletin boards.
- Trophy cases filled to brimming with interesting tidbits ranging from Pastoral Care to art therapy.
- Slides From internal PowerPoints (see picture below) Slides get blown up and “published” to walls throughout the cancer center.
- Posters Well designed posters dot Duke Cancer’s internal landscape.
- Paintings Artist paintings on walls help break down institutional feel.
- Play areas Play areas dot corners and many walk throughs with puzzles, chess boards and even an upright piano.
- Supervisors Leaders are present and they introduce themselves.
- Hospital Entrance. There is a graceful calming water feature inside the main hospital's door. Someone played a large grand piano. It was four o’clock. People were heading home even as some came in.
- Portrait Paintings Paintings of influential doctors and donors are all over Duke’s Cancer center.
Cancer patients are tribal, strong and resolute in face of a common enemy. They will not die today. They force collective bicycle cranks over one more time rising every so slightly until a summit is reached. Reaching cancer’s summit they pause, reflect, take a picture, remember fallen team members, say a prayer, poem, an incantation and they look out into a vast distance for the next mountain to climb. We cure cancer in our lifetime thanks to Duke Cancer’s grace and a resolute tribe of cancer patients and families. United against a common foe humanity gathers the sum of its considerable parts. Cancer doesn’t stand a chance.
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