Aug 20th deadline
Theme: First meeting
“But you don’t expect your son to leave before you.”
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I am a radiation therapist. I started working since 2004. My job is to use radiation to treat cancer patients. Majority of the time, the intent is for cure, or to kill the cancer. Other times, it is for palliative intent. This means the goal is to control symptoms, e.g. alleviate pain, in order to give patients a better quality of life.Depending on the type of cancer being treated, the course of radiation can be as short as 1 day, or can be as long as 7 weeks.
Whenever I tell people what I do, they usually say, “it must be difficult for you.” However, I do not find it difficult. Majority of the patients are in good spirit. They want to fight this cancer so they can become better. There is no denying that it can be scary for them. Often, they have a lot of questions, uncertainties and doubts. Despite all that, they are trying to keep it together, so that they are strong for themselves, and strong for their families. My job, in addition to giving them the treatment, is to walk through this journey with them together.
In between 2006 to 2007, I was working on a machine dedicated to treat pediatric patients. The age range for pediatric patients is from infant to 18. If they are older, we may play a movie on the DVD player, so they can watch during treatment. If they are too young, they get anesthetized before treatment.
Around this time, there was one child who needed to get his brain treated. I am supposed to change his name, but since I forgot his name, I will call him Brandon. In order to make sure Brandon did not move his head during treatment, a custom mask was made for him. Brandon was only three years old at the time, the normal procedure was to give him anesthetic. However, his father did not want Brandon to be anesthetized. He was a father of four children. His wife worked during the day, so he had to take care of all four children during daytime. His children ranged from 1.5 years old, to 7 years old. He had to bring all of the children to the hospital during treatment. If Brandon was anesthetized, they would have to spend an extra 2-3 hours in the hospital for recovery. So we attempted to treat Brandon without anesthesia.
Before I go on, I would like to give some background about the radiation treatment procedure. For patients to receive radiation treatment, three steps have to be in place. The first step is to obtain images of the patient’s body. The patient is placed in a CT scanner, and images are taken, so that the computer can generate a 3- dimensional view for planning, or second step. For patients who receive brain treatment, a custom mask has to be made. The mask is a piece of thermoplastic material. The therapist will put it into a hot waterbath until it turns soft. Then the therapist will place it onto the patient’s face, contour the material and let it cool to harden. Then the patient will be scanned wearing the face mask. The second step, as mentioned previously, is to generate a treatment plan. The doctor, or radiation oncologist, will use the obtained images to identify where he/she wants to treat. The dosimetrist, or planner, will generate a plan best suited for the patient. Finally, the patient will come back to the hospital to receive the treatment. In order to make sure the treatment is delivered accurately, we have to scan the patient, or take some images. The radiation therapist will compare this set of images to the original CT images. If there are discrepancies, we will fix it. Then we will deliver the treatment.
During the first week of Brandon’s treatment, his nurse wanted the same therapists to be present. I happened to be there for his first treatment, so I continued to treat him for the rest of the week. When Brandon first arrived, his father was holding him. He was a small little thing, with black hair and big eyes.
“Hi, Brandon, how are you?” I asked.
He looked a bit scared, and he snuggled further into the father’s body even more.
“What do you have there, Brandon? Oh, a stuffed tiger. Do you like tigers?” I smiled at him.
The nurse introduced them to the area, and brought them into the room. The room had a long winding corridor. Once you turn the corner, you will see a large radiation machine standing there. This machine looks like an upside down L shape attached to the wall. There is also a flat, long and skinny table attached to the ground. Once the patient lies on the table, the L-shaped machine will rotate around the table in order to give the patient treatment. For Brandon’s treatment, we also have a small head rest for his head to lie on, and his mask. We had cut out holes for the eye area, so he could see once the mask is on.
As Brandon’s father lay him onto the table, Brandon started crying and fighting. My partner and I quickly stepped in. The nurse escorted his father out. I will call my partner Josh. Josh’s role was to position Brandon up and down the table for best positioning. My role was to put the mask onto his face. I stood at the head of the table, attempting to place the mask on him.
“Up a bit more toward me.” I calmely, yet firmly, said to Josh.
My partner shifted Brandon toward me. In the mean time, trying to hold him down to lessen the motion. Brandon screamed and cried, twisting his head left to right. Josh slipped his hands under the mask, trying to turn Brandon’s face to point toward the ceiling. I pushed the mask slightly down toward the couch. Once his head was momentarily in the desired position, Josh slipped his hands out, and I brought the mask down quickly to the couch, securing it. Brandon continued to flight inside the mask, crying and pleading to get out of this trap. However, all he could do was tilting his head up and down slightly in the mask. We put a safety belt onto Brandon in order to secure him.
We swiftly exited the room, and started to capture images. These images are a set of static x-ray images of the face and the brain. However, because Brandon kept crying and tiling his head up and down during this image capturing process, it looked like images in a flip book. With the x-ray skull moving up and down and the jaw opening and closing. Josh and I quickly assessed Brandon’s position, made the best adjustment as we could. Then finally delivered the radiation treatment.
The next two days went by exactly the same.
On the third day, I went to the lunch room, and saw my other colleague. We talked about what had been happening. We exchanged our stories. She told me she just treated a patient who had prostate cancer. Cancer treatments usually lasts 7 weeks. This patient was close to finishing his treatment. She said that this patient normally has a very bright outlook. However, it was that day he told her that his son had passed away a while back. She didn’t know what to say to him.
Before she was about to leave the room to give him the treatment, she said to him, “You’re very brave to be having your treatment now.”
He replied, “But you don’t expect your son to leave before you.”
Tears rolled down my face instantly after I heard that. It was the first time I cried after working for 3 years. After treating Brandon for a few days, interacting with his father, and hearing that story. Something touched me in a way I never expected.
Even though I’d been “walking through this journey” with the patients daily, I realized that I do not know how it is like. I do not know how it feels like to have cancer. I can only imagine how it feels like to see your child suffer. I cannot fathom how devastated a parent feels to lose a child. This is not merely “walking through a journey”. This work brings more than that. Hope.
They are dealing with cancer. They do not know what the treatment entails. They do not know what kind of side effects they will experience. They do not know whether the treatment will work or not. Also, they may worry about their family. Who is going to look after their children? Who is going to take care of their ailing parents? They worry about their bodies. What is their significant others going to think? Will they be able to have children? How are they going to get to treatment? There is a tornado of mixed emotions developing in their minds and hearts. So, I do see patients who get very emotional at various course of their treatments. My job, in addition to giving them the treatment, is to offer them care and support to ensure they can get through this part of their journey. Over a period of time, good relationships are developed. So I enjoy what I do.