The 4:30 AM dog walk rewarded me with a lucky find. Perusing the brilliant sky for my favorite big dipper, just to the right a soft sweet teardrop of a falling “star” appeared. The little ditty by Perry Como (!) came to mind “Catch a falling start and put it in your pocket, save it for a rainy day”. I wished I had many to collect for patients facing their rainy day.

Herb is just p…d. ” Doc what the h…? Everything’s gone to sh.. after I turned 70! I got new knees, a heart that beats whenever the heck it wants, and now all this”. What Herb has is skin cancer covering his scalp. “Well Herb, put your big boy pants on and stop whining.(Fire with fire) This is fixable and although the radiation won’t grow new hair (he’s been completely bald for years) you might actually get better looking when this is over and the skin is smooth and clear”. Herb is getting no sympathy from me. He still refuses to wear a hat or sunscreen. He may be cranky but he is actually happy to be here and I know his bluster is for attention. Next door is Carley. She states that she is terrified. As a pre -menopausal woman at 48, she is found to have genetically positive breast cancer and we are planning bilateral mastectomies, chemo, radiation and hormones. The breast cancer journey will take almost a year to complete. Her main issue is caring for her mother, 2 children, working 2 jobs and having to find time for this. Now here is a real problem. There are not enough services to help and her fear isn’t for herself- its the rest of life.

Jane arrives later with daughter and granddaughter in tow. She is a sparky, tough, healthy and witty 90 year old. She is lucky that in the US we still believe in managing seniors with breast cancer (there is even new research to encourage therapy) and so a quick treatment of lumpectomy and IORT (intraoperative radiation- at the time of surgery) is chosen. Pablo is already under therapy and because at 64 we want to preserve as much normal brain tissue and memory as possible, is receiving pinpoint stereotactic brain radiation to 16 (!) lesions in the brain from lung cancer. I warn him the effect on his full head of hair with spotty loss may be comical, but he has a great attitude and says, “Go for it Doc!”

Not one of these cases that afternoon qualifies for the falling star. Know why? This is not their rainy day. Sure cancer is awful and frightening and chaotic. But everyone of them and the 60 others in the center are showing up for outstanding, state of the art treatments. They have a team of specialists putting their heads together to come up with a plan of care. They are not waiting months, laying in an ER for days untouched or being told they don’t qualify for treatment, as occurs in other countries. They have the best case scenerios for even the worst types of cancer. I understand the disappointment patients and their families feel, or the surprise that cancer visits on a person when they were just getting on with life. I fully appreciate that when they are given a diagnosis or scan results and the appointments are set, that they are dazed. But in every single case, every single effort is being made to carry them through with success.

What delighted and inspired me this week is how lucky they all are. We have nurse navigators for every disease type, all specialists available to aid the care and a myriad of procedures such as ‘oscopies, feeding tubes, pain or palliative care management, psychologists, social workers and of course the great and talented staff delivering the chemo, radiation and surgeries.

So nobody qualifies for the rainy day star this week. But be assured that there will be times it burns a hole in “the pocket” when even greater challenges arise. At that time, all the compassion, wisdom and loving care of the team, family and friends will come to support that rainy day and the wish for comfort will lighten their heart.