I remember my sister seemed skeptical when I said: “Of course, I’m going into my appointment today.”
It was in late March—when it was clear that we were all going to be on lockdown in our homes, and masks were no longer just for healthcare workers—and I was finishing up cancer treatment.
There was a lot of panic around the unknown, and most healthcare clinics were closed or only offering virtual visits. I had to postpone annual physicals, dental cleanings and dermatology appointments for my family as they were not critical. But I, like millions of people around the country, could not postpone my oncology treatments and visits. I still had to attend radiation and check in with my oncologist. If I was dehydrated or needed meds, I had to go into the infusion clinic.
Cancer does not take a break during a pandemic.
When I walked into the outpatient cancer clinic that morning, I had a pit in my stomach, but that was nothing new.
What was new upon entering the automatic sliding doors, however, were several new signs and a few nurses sitting at the front desk usually reserved for customer service.
"No guests at this time,” the signs read. “STOP and check in before going to your floor.” I approached, my eyes peeking out from my mask, and stood specifically on the feet stickers drawn on the floor that said, “Wait here.”
Then I was asked the litany of questions which almost seemed ridiculous for someone who was battling cancer. No, I had not been outside the country or state. I was at this office every morning for three months. No, I didn’t have a fever, because if I did, you would have heard from me sooner. And no, I have not been exposed to anyone with COVID-19 as I’ve been locked up in my house for months with little strength to go anywhere or see anyone.
Once I was given the green light to proceed, I grabbed a fresh, disposable face mask at the nurse’s request and I was told it was safe to head upstairs to the waiting room.
When I got there, the place looked grim, but that was the norm. It was filled with sick-looking people. Many were of geriatric age and needed help walking around. And, per usual, I was one of the youngest in the room by about 20 years.
But there were differences. I approached the desk and was told there was no need to sign in. They already checked me in via the computer. I went to take a seat and noticed that there were significantly fewer chairs and each of them were spaced at least six feet apart.
As I sat down and looked around at the covered faces, I realized that I felt safer than ever. Here I was in an office that deals with some of the sickest people in the country on a daily basis, so cleanliness and caution was already a mainstay for the staff. We were all in the same boat as a vulnerable population. So, I was confident that each and every person in this room was constantly hand washing, using sanitizer and socially distancing from anyone sick.
In the moment, this waiting room felt like the safest place to be.
When I was called back to a room, everything appeared to be in its usual place and the nurse continued with her small talk. After the typical, painfully long waiting time, my oncologist came in. Although he had on a mask, I could tell he was sporting that big smile that lights up his entire face. (This doctor always earned an A-plus for bedside manner.)
He seemed unfazed by the world outside his office and was only focused on me and my treatment. In fact, when I said, “Well, at least I’m out of the house,” he responded with: “My wife keeps asking me to wash my hands over and over when I’m in the house. But I respond, ‘Honey, I didn’t have COVID 20 minutes ago and I didn’t pick it up walking around the house.'" The doctor noted how bizarre it was to see everyone washing so frequently when he’d spent years telling his kids to play in the dirt to build up immunities.
The oncologist’s appearance was very different from that of a nurse I saw at the hospital a few weeks later.
The hospital atmosphere was already much less inviting than that of the cancer center. In fact, with no visitors allowed, no loitering in hallways and closed cafeterias, the hospital was eerily quiet.
I headed in for a COVID-19 test, a newly required part of pre-op three days in advance of surgery.
When the nurse entered to administer the test, she looked like something from outer space with scrubs covering every inch of her clothing, two layers of plastic gloves and a face mask underneath a face shield.
She did nothing wrong. She did her job, running through a list of questions, having me sign a form before handing me a paper about getting tested and sending me on my way.
But it was all so methodical, and the difference was all the more stark as her care was delivered behind the armor of her personal protective equipment.
I thought about how off-putting this experience could be to a patient, especially a nervous one about to undergo a procedure.
Both of these experiences were delivered in the same health system. But in one, I felt totally uncomfortable. In the other, I felt … safer.
Perhaps it was the notion that everyone surrounding me knew how I felt, but I was totally comfortable at my remaining oncology appointments.
Cancer, like COVID-19, is a disease for the long-haul.
So, during this pandemic, we cancer patients will do our best to stay safe and be healthy, but not sweat the small stuff.
As for providers, they face a challenge to up their interpersonal skills. If they are going to walk into offices with smiles covered and wearing sterile gear, they are going to have to find new ways to make a patient feel calm and connected.