What do you say to someone who is diagnosed with cancer?
It’s a more difficult question than it might seem.
“It’s one of those things: We’re supposed to be healthy. If we live right, everything goes well. But cancer, it means that there are cells in our body that are trying to kill us,” said Jeff Thompson.
Cancer is a battle not just against a disease, but against the self — an inward struggle that “makes a person feel very out of control,” Thompson continued.
And if a person wins that struggle, they do their chemo and radiation and surgery and come out the other side, they’re often left with long-term side effects.
Or the cancer might come back.
Read other stories in this series at gainesvilletimes.com/cancer.
It’s partly why cancer treatment in Gainesville involves not only an army of techs, nurses, pharmacists, doctors and specialists, but chaplains, counselors and therapists who help blunt the emotional, mental and spiritual trauma inflicted by the disease and its often-debilitating treatment.
Thompson is the director of pastoral care at Northeast Georgia Medical Center. He manages a team of staff chaplains that serve Gainesville and Braselton campuses along with a team of volunteer chaplains from area churches.
All told, a chaplain is on duty all day, every day, in the health system.
“Hospitals confront all of our defenses that think we’re going to live forever. When a person comes into a hospital, they’re confronted with their own mortality,” Thompson said. “When we’re all coping well, we feel like we’re pretty secure. When you lose those, you start grasping for some sense of meaning. We try to help in the midst of that.”
He described it as a journey, saying that chaplains aren’t there to right wrongs or solve problems, but to travel with someone who has received a traumatic diagnosis. They’re a warm presence, a fellow traveler.
Donna Martin Moss is trying to solve problems.
The therapist works in palliative care, the area of medical care focusing on the treatment and management of chronic illnesses such as diabetes, cystic fibrosis, Crohn’s disease — and, increasingly, cancer and its consequences.
“There could be long-term side effects, like neuropathy in their hands and feet, and that could be permanent sometimes,” said Moss, who has been a therapist in North Georgia for 25 years. “They could have chemo brain, cognitively they’re foggier in their processing, in their thinking.”
Those physical consequences can bleed into the emotional and mental. Cancer patients have all of the physical effects of treatment that can affect their moods and states of mind, but those who beat the disease may not be able to return to work or their lives are affected in some other way.
Even when treatment is over, cancer tends to pull at the individual or make them feel different than they were — it can isolate.
“There are things they notice that maybe their families don’t,” Moss said. “It tends to isolate them emotionally because they don’t want to talk about it, and their family is so excited because they’ve completed chemotherapy, they’ve completed radiation — we’re going to move forward in life, and yay, let’s celebrate.
“But life is different for them. So they may celebrate, but their future is kind of uncertain and unknown because of what they’re continuing to deal with.”
It’s different now for Michael Ramirez, who went to the doctor at 29 years old after feeling lethargic for a few days. Expecting to get a flu diagnosis and a recipe for chicken soup, Ramirez, now 31, was told he had Hodgkin’s lymphoma.
He worked for Domino’s at the time, leaving him with not much of a health plan. The cost of his care was written off and the charity Glory, Hope and Life stepped in to help cover his prescriptions.
The experience put him out of work during treatment and has left him feeling removed from his extended family. His mother died when he was 18 and his father when Ramirez was 28.
He’s been a client of Moss since the end of his treatment.
Ramirez had worked since he was 17 years old, but stuck with low-skill food service jobs.
He’s back at work at Domino’s since completing treatment, but the ordeal left he and wife, Darlene, who moved to Dawsonville from Ontario after meeting Ramirez online, emotionally and financially drained.
“I’m 31, and I get up out of a chair and walk like somebody twice my age,” he said, later adding with some sardonic laughter, “There’s a reason we’re seeing Donna.”
Ramirez has continued visits with Moss in the year after he concluded his medical treatment. Feeling as if he doesn’t have family to lean on, a relatively low-paying job, few connections in Dawsonville and no faith community to lean on, cancer cut the legs out from under the couple.
Moss said she’s seeing more people in situations like the Ramirez family — people who have fewer connections to tap when they’re struck by an illness.
“We’re a bigger society. Our families are more scattered and more isolated,” she said. “It lends itself to people being more isolated. If you don’t create your own ‘family’ from friends and associates and colleagues and support groups, you do tend to be isolated.”
The people who handle the effects of the disease most successfully — not necessarily the damage it does to the body, but the stress it puts on the foundation holding a life together — are those able to hold onto some meaning in their lives.
“I think whatever faith base someone has is very helpful, from what I have seen, and having a renewed sense of living — having meaning, making something have meaning out of it,” Moss said.
But even for those with a clear purpose or a strong faith, lymphoma or leukemia or lung cancer and their treatments can be a challenge difficult to even discuss.
Not for the chaplains.
“A lot of people don’t know what to say about cancer. Even at this day and time, it’s kind of like it’s got this magic curse on people. Some people are even afraid to talk about it because it’ll affect them — or they just don’t know what to say,” Thompson said. “A person who’s never had anything bad happen to them in their life that they didn’t want, they’re still that person. Just because they have cancer doesn’t mean they quit being who they are.
“Sometimes, being sensitive to listen if they want to talk — or if they don’t want to talk but just want some company. We’re not there to try to help fix things. We’re there to try to journey with people.”