Verna Mitchell has an unusual window on the world of childhood cancer. She's the nurse practitioner who works with cancer survivors at the Health After Therapy clinic at Lucile Packard Children's Hospital.
Mitchell's patients are children, teens and young adults who are at least five years past a cancer diagnosis. As I describe in a new Stanford Medicine magazine story about pediatric cancer survivorship, the HAT clinic helps these young patients grapple with the challenges of survival. The fallout from their cancer treatments can include a variety of physical, emotional and cognitive difficulties. But there's more, too:
“We tell them that the clinic’s purpose is not just to point out potential late effects,” Mitchell says. “It’s to say, you have your life, your health. Make the best of it that you can.”
After years of being in battle mode against cancer, this is a significant shift of view for many patients.
Mitchell provides lots of practical support – referrals to specialists who assess cognitive performance or provide psychotherapy, for instance. And yet how does she handle the more nebulous part of her job, fostering hope and helping patients make the shift to valuing their survivorship? At the end of my conversation with her, I asked.
"I tell them that they survived a very catastrophic illness at a young age; they fought for their lives during that time," Mitchell said. She worked on the front lines of pediatric oncology for 10 years before she began treating survivors, so she has had an up-close view of the fight. As she puts it, "I don't have to give chemo anymore, but I know what the patients have been through."
After they win the battle, Mitchell said, she tells her patients, "They are true survivors. And when it comes to facing the challenges that life brings them, they are, in general, more mature. They've been taught about life, about adversity. They may not have realized at the time that adversity came in a tube and went into their arm, but it's something these families have learned: that they can survive adversities. It makes them stronger individuals with a lot of character."