New program offers lung cancer patients
Grace Licata had her husband and three grown children with her the morning she was told she had inoperable, stage IV lung cancer.
Rochester General Hospital attending medical oncologist Peter Bushunow, M.D., delivered the diagnosis, the family listened in astonishment to the news of multiple tumors – Licata had never smoked – and Meredeth Paddock, sitting next to the doctor, prepared to provide some comfort.
At the end of the appointment, Paddock handed her card to each family member and pledged to offer whatever support was requested. As coordinator of the Lipson Cancer Center’s relatively new Lung Cancer Care Coordination Program, she is the first point of contact for patients who may need help with processing emotions, scheduling appointments, understanding medical jargon, finding community resources or any number of needs.
Most important, as that point of contact from the first suspicious finding through recovery, she serves as the one constant in the lives of those struggling with a seemingly interminable list of questions. And Licata’s family had plenty. Everyone phoned, sometimes daily.
She was heaven sent says Licata, 72, who is in remission after radiation and chemotherapy treatments. “I would say, ‘I hope I’m not bothering you,’ and she would say, ‘No, just call anytime.” And she meant it. I don’t know what I would’ve done without her.”
When Rochester General Hospital decided to launch the supportive program last fall, administrators looked to Paddock, who had held a similar position several years ago at the Moores Cancer Center at the University of California in San Diego. Because of her previous experience, she helped write her current job description, which includes working collaboratively with family physicians, surgeons, radiation oncologists, medical oncologists, radiologists, pathologists, dieticians, social workers and other health care professionals.
Paddock usually is in the room when patients learn of their diagnosis. Once the doctor leaves, she spends time talking with patients and their families about what to expect at the next appointment, as well as what treatment options may be available, and passes along educational materials that include tips for eating well while battling the disease. If a patient requests test results over the phone, she calls the same day. In both cases, she says, the conversations “really have made patients feel more at ease coming to their first appointment at the Cancer Center, which can be very scary, especially when they know nobody there.”
Diane Czebatol remembers vividly how nervous she felt at that first appointment this past January, after having a brain MRI, abdominal CT scan and nuclear bone scan to determine whether the cancerous mass just found on her left lung had spread. Paddock had the results. Says the 53-year-old: “The first words out of her mouth were, ‘I have good news.’
My mom and I started to cry and we gave Meredeth a huge hug. A wonderful patient relationship and friendship had been formed from that moment on.
“I just can’t say enough about her,” she adds. “She was there to reassure me this is not the worst-case scenario."
She gives me the hope and the positive attitude to get through this. I’m sure she gets tired of repeating herself to me for the reassurance I need to go on, but you would never know it.”
Czebatol and other patients are quick to point out that Paddock usually answers phone calls and e-mails immediately, and never goes more than two hours without responding.
The gratitude goes both ways. “Whenever I meet anyone new and tell them what I do for my career, I always get the same look of awe and amazement,” says Paddock. “They always say to me, “How do you do what you do each day? Doesn’t all the sadness ever get to you?” My general response is that the patients I work with and take care of are all amazing in what they have to deal with in terms of their diagnosis and treatments. Not one of them ever comes to the clinic angry or upset. They know they are there to fight. They have taught me so much.”
Paddock took a break from oncology work in 2001 after her father, who had battled lung cancer for a year, passed away. But she returned after two years, once she realized that working with cancer patients was more a calling than an occupation. “Many of those things have been streamlined.”
“I fully believe that God and my father directed me to this particular job because it allowed me to put myself in the shoes of the patient and the family,” she explains. “I feel I am able to better educate and guide them because I know what they are going through.”
Medical providers benefit from her role as well. Dr. Bushunow notes that Paddock’s expertise includes being able to relay critical information among medical departments in a timely manner, an increasingly important function as departments offer more interdisciplinary care.
And that, in turn, makes her a trusted advocate. “You no longer hear about somebody waiting a week to see a doctor, only to be told that they really needed to see this other doctor,” Bushunow says.
Medical oncologist Julia Smith, M.D., found herself grateful for Paddock’s close involvement recently, when one of her colleague’s patients, who was quite sick, was admitted to the hospital during her shift. She found herself presiding over a meeting with the patient’s relatives. “A lot of decisions were being made,” Smith recalls, “and it was nice having Meredeth there because she had known this woman from the beginning as an outpatient. She was able to help me focus questions and be prepared ahead of time.”
For the patients, though, the Lung Cancer Care Coordination Program is a lifeline.
Licata recollects the morning, shortly after being diagnosed last October, that she called Paddock immediately after spitting up blood: “I was devastated. I ran to the phone and I told her I thought something was wrong. She said it was very normal. If I didn’t have her to call, what would I have done?” Licata’s husband, Walter, can relate. He appreciates Paddock understanding that family members sometimes require as much shoring up as the patient. “You can’t call doctors with all these questions,” he says. “They wouldn’t be doing any work.”
Through the overwhelming, confusing maze that the health care system can be, Paddock is always there – especially in those doubtful moments when even a good prognosis doesn’t seem good enough.
“When you get this stuff, you don’t trust too much anymore,” admits Czebatol. “Even though she’s not guaranteeing anything, Meredeth says that I have what I need behind me to kick this. It means so much to hear something like that from someone like her. “It’s just more humane.”
Story by: Robin Flanigan
Photos by: Lisa Hughes