On Tour at Cancer Treatment Centers of America

I absolutely love being self-employed. I’ve been my own boss for almost twenty years now. But if I were ever going to punch a clock for someone else ever again, I think I found where I would want to work: Cancer Treatment Centers of America. I had the opportunity to visit their facility outside of Chicago last week—they knocked my socks off!

When you arrive at CTCA you are greeted by a couple of valet attendants, who for no fee (won’t even accept a tip) park your car for you and escort you inside. When you enter, immediately you begin to feel the warm energy emanating from this place. On the wall to your left, a brass tree with leaves baring the names of patients who have celebrated at least 5 years of life since arriving. You then pass a large aquarium with beautiful fish on your left and a beautiful atrium with plants and soothing music to your right. A friendly person at the reception desk greets you and quickly determines how to best suit your needs.

The hospital looks more like a hotel (The Ritz, not the Super8), with heavy wooden doors and molding on all the wings, attractive carpeting beneath your feet and beautiful artwork and heartwarming pictures in all the hallways. Rarely will you hear an overhead page (“It disturbs the sleep of our patients,” I was told.)

CTCA boasts the finest state of the art equipment, but what really makes them special isn’t the high tech—it’s the high touch. The founder, Richard Stevenson, created CTCA based upon what he calls the Mother Standard® of care. In the 1980s his beloved mother developed bladder cancer and he searched across the country for someplace that would give her the care he felt she deserved. Finding none, he determined that he would create a place, himself. Each person would be treated with the same unconditional support, warmth and respect that one would want for their own loved one, because everyone is someone’s mother, father, sister, brother, daughter or son.

Katherine Puckett, PhD and Director of Mind Body Medicine at CTCA is one of the most down-to-earth folks I’ve ever met. She told me of a time when she was seeing a patient in her office. Katherine apologized for the piles of reports and files that lay on her desk. The patient smiled and said that he found her office comforting, then explained, “It’s evident that you place people before paperwork.” That’s the mindset in this place—how comforting!

CTCA offers a comprehensive and integrative approach to fighting cancer. Traditional tools for fighting cancer such as surgery, radiation, chemotherapy and immunotherapy are combined with complementary therapies including nutritional support, physical therapy, pain management, naturopathic medicine, spiritual support and mind-body medicine. This enables patients to better tolerate the treatments which can kill the cancer, but can also be devastating to their physical and mental health.

One of the approaches used in the Mind-Body Department is humor and laughter. Dr. Puckett and several other staff members took training several years ago to become Certified Laughter Leaders (CLLs). Since then, numerous other staff have been trained and now laughter therapy, or Laughter Clubs are offered regularly for patients and their families. Participants come away feeling healthier, happier and more energized.

Kudos to the folks at CTCA. They get it. The patient is the focus of all that is said and done. Like I said, I’m not really looking for a job, but if I were, I hope I could make the cut. It would be a real privilege to work among such great people.

Humor, Cancer and Chronic Illness

“I’m not afraid of dying.  I just don’t want to be there when it happens.”  Woody Allen

 
Pat’s hand gripped mine tightly– her eyes glistened with mischief. “I so look forward to your visits. Everyone else around here is so darned serious!  I wish they’d just lighten up a little.”  I looked around the room and she was right. Her 58-year-old husband and 32-year-old daughter sat on the couch, looking as if a smile would shatter their faces into a million pieces.  “Tell me something funny that happened to you this week,” she continued. “What’s that little boy of yours been up to now?”

Pat was one of several patients that I made home visits to as a nurse, following up after her chemo and radiation for a tumor in her neck and jaw. Physically she was doing fine and her outlook was tremendous. However, her family had an attitude that could sink a battle ship. Even though Pat valued laughter, her family felt her condition was much too serious to permit using humor.

 
Despite the tremendous advances in cancer treatment, just the word “cancer” evokes a visceral reaction in many people. This includes family, friends, and even some health care providers. One of my patients shared that when she attempted to make a joke about her condition, her husband reprimanded her: “Honey, you shouldn’t be making jokes.  Don’t you realize how serious your condition is?”  This came as no surprise to me. A survey of terminally ill patients showed that over three fourths of them said they wanted more humor but that their family would not joke with them.

Does humor serve a purpose for those with terminal or chronic conditions?  Absolutely. Humor serves many purposes, including relieving anxiety, managing painful feelings, and releasing anger in a socially acceptable way. Humor is a wonderful coping mechanism that can help by reframing or seeing situations in a new light.

Distraction serves as another useful purpose. Sometimes humor helps to divert our attention, instead of focusing on what’s stressful to us at the moment. Humor can often provide relief, whether it’s from an uncomfortable needle stick or the unpleasant side effects of a medication. Scientists are collecting more evidence every day that humor, laughter, and positive emotions have numerous physical benefits, including a decrease in muscle tension and an enhanced immune system.

 
Where do you find humor? Fortunately it’s all around you. You just have to be looking for it. It’s a mindset, an attitude. It is not the same thing as joke telling, which may come as a relief to some of you. However, if you want to learn to tell jokes, practice telling a joke out loud to yourself seven times before you attempt it with someone else. (Once you blow the punchline, there’s no saving it.) 

Better than jokes are personal experiences or embarrassing moments. Few adults have not locked their keys in their cars, or found their zippers unzipped, or discovered a colorful piece of food stuck between their teeth when trying to impress someone. When sharing these universal events, we share our vulnerabilities and our willingness to trust others.  If you can see any humor in it at all, try sharing an embarrassing moment with a friend or family member.

Schedule some time for play daily. Many folks this frivolous and their lowest priority, but research now indicates that those who are too serious to allow time for play wind up seriously ill. Make a “list of things you find pleasurable and fun to do (some of these ideas should be of little or no cost). Then when you are most in need of lightening up but unable to think of anything fun to do, pull out your list and make an agreement to do at least one thing. You will feel better afterwards.

 
Get out of your rut. Do something out of the ordinary. It can be something as minor as sleeping on the other side of the bed, listening to a different type of music than you’re accustomed to, leaving for work 20 minutes early to take the scenic route, paying for the toll of the guy behind you, sending a cartoon to a coworker, taking a bubble bath by candle light, calling an old friend from high school— just use your imagination!  I once watched in bewilderment as a friend tossed his loose change into the couch in his hotel room.  “What are you doing?!” I exclaimed.  He smiled and said, “Even though I won’t be here to see it, someday someone’s going to have fun discovering the money in this couch.”

No matter what your physical condition, humor can benefit you.  Plan a daily humor break and reap your profits. Make the most of every day– lighten up!

Stress Busters

There’s no one coping mechanism that will work for every stressful occasions. People need a variety of skills to stay healthy. These could include deep breathing exercises, progressive muscle relaxation, and meditation just to name a few.  But the benefits of humor and laughter are so plentiful, so convenient, and so cost-effective that people would be foolish to leave these awesome coping tools out of their coping toolbox. 

Here are a few quick stress busters. Try one the next time your energy level drops and your attitude is sagging:
 
Call your own answering machine or voice mail to leave a humorous message that you can enjoy later. Bonus—you get to laugh twice: Once when you leave the message and again when you play it back.  (For example: “Just calling to remind you to be careful when you go by the post office to pick up stamps and be sure to wear clean underwear because you never know when you might be in an accident!”)

Keep a file folder at your desk with clippings, cartoons, and e-mails you find entertaining. Pull it out and refer to it when you’re put on hold or when you feel those shoulders tightening.
 
Keep a book of word games, crossword puzzles, or cards at your desk. Re-spark your creativity and energy by taking a daily 10-minute ‘play break’ and you’ll recognize how important it is not to wait until you feel better to play. Play and then you’ll feel better.
 
Got a problem that’s bugging you?  Practice playing with your pain by asking yourself “how could this be worse?” Exaggerate the situation until you can make it absurd enough to put things in their proper perspective.
 
Smiles and laughs can diminish muscle tension. They’re also contagious. Practice wearing a smile to share with others and notice how their responses make you feel better, too.
 
Gain maximum benefits by proactively seeking humor every day.