Sally and Me
The Florida sun was shining brightly through our hotel window, providing a beautiful view of a lake, with Space Mountain in the distance. “I’m sad that you’re leaving today to see your family,” Sally said as we packed up our things. “But I know that if I miss you, then they must miss you a lot, too…so I guess I understand.”
I had just spent three amazing, tiring days at Disney World with this six-year-old girl, her eight-year-old sister Imogen and her mom and dad. Each day was filled from morning to night with theme parks and swimming pools. At the end of this adventure, I planned to stay a few days with my own family in Ocala, Fla., before flying back to begin my last year of medical school at Tufts. Although we’d both be back in Boston soon, I struggled with saying goodbye.
When I decided to be a part of KICS my first semester of medical school, I never knew Sally would become such an important part of my life. Kids in Chemotherapy and Their Students (KICS) is a mentoring program in which medical students are matched with a child diagnosed with cancer.
The organization was founded in 1988 by medical students Kathy Foster, M90, and Ari Baron, M90, with the help of social worker Madelyn Bronitsky, after their third-year pediatric clerkship. The idea came after observing the personal struggles these children were going through on a daily basis, which ranged from completing homework to dealing with the physical changes of steroid therapy, all while undergoing treatment for their cancer.
Six to nine students participate in the program each year. Becoming a part of this organization is an extensive process. Members are determined by a written application followed by personal interviews conducted by the social worker and the previous year’s members to determine who best fits the personality of the child. It is also important to determine who is willing to dedicate the time to their child while balancing the emotional weight of the experience.
Although pediatric oncology has made tremendous advances in the past 50 years, not all cancers are curable. Death is a possibility, and I have known two members who have seen their matches pass away. Getting well can also mean no longer being close by, which is the case for a few of our matches who have come from Puerto Rico for treatment in Boston. Regardless of the challenges, everyone involved would never take back their experiences.
The depth of the relationships within KICS can be surprising. Although the minimum commitment is two years, I had heard stories of matches staying in contact long after medical school. I was lucky enough to have something like this happen to me. I was paired with a little girl with leukemia, and my experiences with her have shaped my life and have influenced my future career in medicine.
Sally was three when I first met her, though she looked much younger without her hair. She had just finished her first month of chemotherapy on the seventh floor of Tufts’ Floating Hospital for Children. Sally had a charisma about her that made a lasting impression on everyone who met her, and I was no exception. Sally’s bright blue eyes would light up with excitement when she saw me. Grinning widely, she would hug me, saying, “My Meredith!” (though at her young age, it came out a little more like “Meredif”).
I made it my priority to be with Sally through every aspect of her treatment. If I knew she had an appointment, I made sure I could be there to spend time with her, making up games about Mulan (her favorite movie) or coloring and painting with the multitude of arts and crafts supplied by Child Life, one of the nation’s first hospital activity programs for kids. I also provided a helping hand to her mother, an amazing woman with a post-doctorate in evolutionary biology who wrote science fiction on the side while caring for her two children.
Managing the toys, movies, baby carriage, juice boxes, snacks and Sally was an impressive feat even with two of us. Appointments can last hours, so between all the supplies a prepared mother can bring, combined with an active little girl still hooked up to an IV, it never hurts to have the extra help. I wanted Sally to realize that no matter what was going on during her treatment, she had someone who was there just for her. No needles, no exams. My only role was to make her happy and to be her friend.
I did my best to keep her entertained and distracted by singing Disney songs while she fasted for hours in the clinic before procedures. I had so much respect for her mother during these times and throughout her treatment. Sally would be content one moment and then be overcome by hunger, crying for just a juice box. It’s a lot to expect a three-year-old to understand why she isn’t allowed to drink. Sally’s mother would skillfully soothe her daughter as she explained why she would have to wait a little longer.
Sally and her mom had a tradition on procedure days, and I quickly learned their routine. Sally eventually would be brought up to the PICU sedation room on the sixth floor of the Floating Hospital. After she was placed under sedation, she would receive injections of chemotherapy into her spinal fluid to prevent the cancer from spreading to her brain. The whole process would take only an hour.
Before Sally would even wake up, her mom and I would be ready with a McDonald’s chicken nugget Happy Meal and a chocolate croissant from Au Bon Pain. Still groggy from anesthesia, she would happily chew her French fries.
Feeling in the Moment
I was there to celebrate each of Sally’s birthdays and to dance with her at the Cancer Center holiday parties held at the clinic for all the children and their families. KICS would provide activities for the kids, including cookie decorating and ornament making.
Most importantly, though, I remained in her life as she completed her chemotherapy and got well. Her weekly appointments became monthly, so her parents and I started making frequent breakfast plans and times for me to visit Sally at home. She and her family lived in a duplex apartment on a quiet street in Jamaica Plain with a neighborhood garden in the back where children could play.
It is all too easy to be consumed by the academic rigors of medical school—lectures, exams, notes, anatomy lab—requiring us to look at health care in abstract terms. But there was nothing abstract about this little girl, or the way she faced her cancer. The resilience of children like Sally is what draws me to pediatrics. With adults, I often feel we allow our diagnoses to define us, to dictate how we feel. With children, their behavior is affected by how they feel at that moment, not by how they expect to feel.
I have been a part of Sally’s life for almost four years now. At the beginning of her treatment, Sally had surgery to place a portacath, an indwelling catheter below the skin in her chest to allow for frequent blood draws and chemotherapy. Six months ago, I was with Sally and her family to celebrate its removal. I even surprised Sally with a “No More Port Party” at her favorite brunch spot, bringing her a giant cookie cake with “Congratulations Sally” written in pink and purple frosting, her favorite colors.
Sally is the strongest six-year-old I have ever met, both mentally and physically. She plays T-ball, takes swimming lessons and is excited to tell me everything she is learning in kindergarten. I have watched her grow up, maturing from a toddler to an insightful, intelligent young girl. She has maintained that charisma and energy that surrounded her throughout her treatment.
While we were at Disney World, it was very important for Sally to go on a “big girl” ride for the first time, just with me. As we climbed the first hill of Thunder Mountain Railroad, I saw the excitement in her eyes. “Where are the big drops?! I thought that was supposed to be scary!” she exclaimed when the ride was over, obviously proud of her accomplishment. She maintained this bravery throughout her treatment, and I know she will carry it with her for the rest of her life.
Sally says she wants to be a doctor when she grows up. I plan on being at her White Coat Ceremony when that day comes, along with her many other milestones along the way.
Meredith Posner, M12, who was co-president of KICS in 2009–10, intends to specialize in pediatric medicine.
This article first appeared in the Winter 2012 Tufts Medicine magazine.