Halloween is here and its nice to see some playfulness in the centers. I encourage staff who wish to dress to be clever and fun, as opposed to ghoulish. No one wants Dracula with the bloody teeth taking their blood pressure. When I enter Exam room 1, I wonder if Billy is dressed as a Biker to get into the spirit. The burly, heavily bearded and tatted gruff guy doesn’t need a costume. He appears to be brushing off the therapy for lung cancer like a gnat. I have difficulty hearing his breath sounds with the stethoscope due to his large body habitus and since I am new to him I quietly say, “Smoking?” He is comically offended. “Doc, I did a lot of drugs, marijuana, coke and smoked my whole life, but when I had that heart attack a few years ago, I gave it all up.” Here is an interesting fact I see often. I am almost jealous of heart disease. Patients will stop smoking on the spot, no patches and vape or little crutches to get off the cigarettes. Heart attack? Boom, done! Cancer? not always. Cancer seems to not make a big movement in the needle. Maybe patients feel fatalistic about it- although we have a ton of algorithms to follow to get patients to stop. It’s not judgmental. Fact is that the radiation is not as effective if a patient smokes. I like Billy. He is no nonsense and tough. He will manage this well.

In room 2 is Natalie. She is wearing the fashion-required grandmotherly Halloween sweater and has her two grandchildren in tow, decked out as a princess and transformer. The attention goes directly to them and she beams, leaving the breast cancer a non-issue. When I pass the chemo room with its barco-loungers lined up, I glance to see Gretchen, treating for a very unusual gall bladder cancer, climb into the chair. Her black and orange pumpkin socks peak out. She is weary but I admire that she took that effort.

Again and again, the center will buzz this week with spirits of all kinds. But by far, the costume I adore is the most ubiquitous and powerful. Every patient will enter, their shoulders back, head high, with determination and a smile. Their “spirits’ will haunt and inspire each other. They will fight evil and they will be our super heroes as they battle for their lives. Making the world a better place.

Happy Halloween.