By Claudia Chan

Disclaimer: Names have been changed to protect the identity of those involved.

 “Hello, my name is Claudia, and I’m your radiation therapist.”  I introduce myself to Brandon and his father.

 Brandon is 3 years old.  He is getting treatment for his brain cancer.  This is the first day of his four week treatment.  His father is carrying him into the treatment unit.  He has short black hair and big brown eyes.

 “Hi Brandon, how are you?” I ask him.

 Brandon looks a bit scared. 

 “What do you have there, Brandon? Ohh, a stuffed tiger. Do you like tigers?”

 Brandon turns his face and hides in his father’s neck

 One week ago, his nurse informed us about Brandon’s situation. Normally, children that age are treated under anesthetic.  However, Brandon’s father hopes that he can do it without. If he is anesthetized, everyone has to stay an extra 2-3 hours until he recovers. He has four children, and his wife works during the day. The whole family has to come to the hospital for Brandon’s treatment, so we are attempting to treat Brandon without anesthesia. 

 His nurse walks in at that point.  “Hi, Claudia, how are you?”

 “I’m good, Bernice.  Josh is setting up the room.”

 “Okay. I’ll show them around.”  Bernice brings Brandon and his father into the room.

 Josh, my partner, is setting up for Brandon.  He has Brandon’s face mask, a piece of thermoplastic material used to keep his head from moving during treatment. To make it, a therapist puts a flat piece of thermoplastic into a hot water bath. Once it turns soft, it is molded to the patient’s face until it cools and hardens. The patient wears this mask for the CT scan, which takes pictures of the patient’s body.  The result is a 3-dimensional view of the patient’s body in the computer. The radiation oncologist, or doctor, uses this information to identify where he/she wants to treat. The dosimetrist, or planner, generates a plan best suited for the patient. Once the plan is ready, the patient comes back for treatment.

 To get into the treatment room, I have to walk past a thick metal door and down a long corridor. Around the corner stands the large radiation machine, attached to the wall, resembling an upside down L. Attached to the floor is a long skinny table, called the couch, for patients to lie on. Once the patient is set up, the L-shaped machine rotates around the couch to deliver radiation.

 I approach the machine and pick up the mask as Brandon’s father lays him on the couch.  Brandon starts crying and fighting.  Josh and I quickly step in and take over.  Bernice escorts his father out of the room. 

 The majority of the time, the intention of the treatment is to cure cancer. Other times, the goal is to control symptoms i.e. alleviate pain so patients have a better quality of life. Whenever I tell people what I do, they usually say, “It must be difficult for you.” Though I do not find my job difficult, there is no denying that it is a scary experience for the patients. Often, they have a lot of questions, anxieties, doubts, etc. Despite all that, most patients are in good spirit. They want to beat cancer. In addition to giving treatment to my patients, I feel my job is to walk through this journey together with them.  In this case, our goal is to cure Brandon. 

 Josh holds onto Brandon as he kicks and screams as I stand at the head of the couch giving him directions.  Josh’s role is to position Brandon so that I can put his face mask on. 

 “Up a bit more toward me,” I calmly, yet firmly, say to Josh.

 Josh shifts Brandon toward me while holding him down to lessen the motion. Brandon screams and cries, twisting his head left to right, kicking his little legs in the air. Josh slips his hands under the mask, turning Brandon’s face to point toward the ceiling. I push the mask slightly down toward the couch. Once Brandon’s head is momentarily in the desired position, Josh slips his hands out, and I bring the mask down and secure it to the couch. Brandon continues to fight inside the mask, crying and pleading to get out of this contraption. However, all he can do is tilt his head up and down inside the mask as he cries. We wrap a blanket around Brandon and put a safety belt on to hold him in place.

 Josh and I finish setting Brandon up by bringing the couch to the desired position, and we exit the room.  To make sure that we deliver the treatment accurately, we proceed to take a set of conebeam images, or a mini version of a CT scan.  As we start to take the pictures, a snapshot of his entire skull is shown on the computer monitor. Because Brandon keeps crying and tilting his head up and down during the scan, the x-ray images look like they are from a flip book. One shows a skull tilted up with the jaw open, another shows a skull tilted down with the jaw close.  All the while, Brandon’s cry can be heard through the intercom, and it is in sync with the pictures being shown on the screen.  This gut-wrenching sight grips my heart.  Once the conebeam is finished, I assess Brandon’s position. We make the best adjustment we can to fix any discrepancies, and we deliver the radiation as quickly as possible. 

 After we finish his treatment, his father takes him off the couch.

 “Brandon, you are all finished.  Do you want to choose a sticker?”  I ask him. 

 He looks at me apprehensively.  I show him a sticker box.  His father helps him choose a baseball sticker and puts it on his progress calendar. 

 “Look Brandon, now you have one sticker on your calendar!  Great job!”

 The next two days go by exactly the same.

 On the third day during my break, I go to the staff lounge to take a rest.  My other colleague, Elaine, walks in momentarily after.  “Hey Claudia, how are you?”

 “I just finished a pediatric case.”  I tell her my story. 

 “Oh… that is so sad,” Elaine replies after listening to my story.  “I just treated a patient who told me his son passed away earlier this year.”

 “Oh, what made him tell you that?”  I ask her. 

 “I don’t know.  He’s been having treatment for five weeks now, and he had been quite happy.  But for some reason, when I started setting him up today, he told me about it.  I didn’t really know what to say to him.”

 We both fall silent. 

 “After I finished setting him up and was about to leave the room, I said to him, ‘But you’re very brave to be having your treatment,’”   She continues.  “Then he said, ‘But you don’t expect your son to leave before you.’”

 Tears instantly rush down my face. It feels as if a dam has broken. I have been working for about 3 years, and this is the first time I cried. 

 On the fourth day, Brandon is about to start crying when Josh turns on the DVD player.  Thomas the Train comes on the screen, and it is enough to capture Brandon’s attention. We set him up and treat him while he watches the DVD.   

 The following week, Brandon wants to walk into the treatment room.  I follow behind him and his father, watching him waddle down the corridor while holding his father’s hand.

 Even though my job is to walk this journey with patients, I realize I barely understand it. I have always heard the saying, don’t let cancer define you. However, these few days showed me what that truly means. It makes me realize that fighting cancer is not the only thing.  Each patient is dealing with real life other than cancer. Moreover, everyone in the patient’s life is affected in some way.  That is why people say cancer affects everyone.  Not only is the patient affected, but the people in their lives are also affected.  Since Brandon, I also try to connect with the people who come with my patients in addition to taking care of them. Even though I am only present in a very small fraction of their lives, I hope that my presence and support will help both the patient and their loved ones in some way.

 One day after Brandon finishes his treatment, he picks out a tiger sticker.  He smiles and shows it to me before putting it on his progress calendar.  He has two more sessions until he completes his treatment. Even though he has never said a word to me, his smile is all that I need to see.

Becoming Writer
Becoming Writer