To Ring or Not To Ring

Watch any TV show or movie about cancer and you will see the patient celebrate the end of treatment – cupcakes, balloons, all smiles. In radiation there is a tradition of ringing a bell to mark the end of treatment – a symbol of the celebration. Our society is trained to think every patient should and does celebrate the end of treatment with exuberance. I suppose patients themselves think this is how it will all go down.

Usher in reality. The end of treatment is scary, uncertain and anxiety provoking. That "celebration" may end in tears on the car ride home. It's something most people can't understand because they haven't been there.

Remember, the "patient" (include in that their caregiver) has been seeing this care team monthly, or even weekly, for many months. They have been a lifeline, a support that has gotten the patient through a life-altering experience. And they just said, "congratulations, you're done! We'll see you in 3 months." Many patients feel the rug pulled out from under them, wonder what is next, who will be checking on me? It can be a scary time and we need to remember that.

As a friend or caregiver, remember that it isn't all balloons and cupcakes. The experience doesn't go away tomorrow. Be there, provide support and understand that it takes time.

As healthcare providers, don't stereotype the end of treatment. One size doesn't fit all. Not everyone wants to ring the bell – and that's ok. We are here to support our patients in whatever way they need us to.

I have written often about my cousin and her cancer experience. She was not one for attention and loathed the idea of ringing the bell at the end of radiation. But, she was also not one to disappoint. Her nurses talked about ringing the bell and she didn't want to let them down. What could she do? She snuck out a back fire stairwell and called me from the lobby. She had successfully avoided the bell – but also avoided setting up a follow up appointment!

Cancer brings many emotions to the table. There is no "normal." Everyone's experience is their own – and that is ok. I support them all - hope you will too.