That was how this began, this book about people who help other people, who, in their difficulties, find ways to hold their hands out to others in need. Peg is going to tell you my story, how it all began. She had been there from the beginning, first as a friend and co-worker and now as my nurse. She can tell my story better than I can. So listen to Peg, and she’ll tell you how it started and how she feels about it, and then we’ll all tell you the rest of the stories.

I had been there from the first, when the melanoma was diagnosed six years ago. Carolyn was coming for dinner that spring evening, bringing some take-out Chinese food. Her husband Jack was teaching during the evenings, so we spent time after work together talking about her project. I expected her usual cheery self, ready to sit down with her tape recorder and let me tell her about my patients. We had several sessions like that, her not knowing quite where she was going with this project, only knowing she had to tell the stories of our patients.

“It’s not a book yet, just a transcript of some stories from my friends,” she told me. “It’ll become a book, but I’m not sure how.” She kept working at it, interviewing people and writing everything down. But when she came that evening she walked in the door without the Chinese food she had promised, and I knew something was wrong.

“I’ve just been diagnosed with a Clark’s level three melanoma in my left ankle.” Simply said, and if I hadn’t seen the fear in her eyes I would have thought she was kidding. Melanomas are serious skin cancers, graded by Dr. Clark from One, which is not going to spread, down to Five, which is the worst. She had a Three, somewhere in the middle. It was a tiny mole, and never had the characteristics of a typical melanoma. She had gone to the doctor and he took it out and did a biopsy, and he didn’t think it was much of anything, either, probably a pigmented mole of some kind. When the news came back, she was shaken.

She sat down and I looked at the biopsy site, the unhealed quarter-sized hole on the inside of her left ankle. I took her leg in my lap and tried to explain what would happen, knowing that she knew quite a lot about it, but also knowing that she was now the patient, not the nurse. And I had to be more nurse than friend right now, because that’s what she needed.

“They’ll make a wide excision here,” I drew a line with my fingernail around an area about three inches in diameter. “They’ll take a graft from there,” and I pointed to her thigh, “and you’ll sit with your feet up for a while and let it heal.”

I looked over at her, sitting there with her eyes closed. “I know it’s hard to imagine sitting for six weeks but you’ll have to do it.” Brisk, I thought. She needs me to be brisk and collected. “You’ll do it.”

She nodded and opened her eyes. “Then what?” she asked.

I shrugged. “Then keep writing, get a job, and pray it doesn’t spread. That’s what.”

We put something together for dinner; she sat quietly and ate and we talked about other stuff. When she left in the cool night I gave her a hug and watched her pull out of the driveway. She waved, and I waved, and went back inside and leaned against the door, and wondered what kind of journey we two were going to take. We were good friends; we had worked together for a long time years ago. And now she was a patient as well as a friend. I’ve been a cancer nurse for a long time, and each patient is special, but this was going to be very hard.

She healed, of course, and the graft took because she did sit for six weeks and watched TV and worked on her book and was patient. She got a job as a school nurse in the district where she lived, and within four months of surgery was working full time.

“Best thing I could have done,” she told me. “At first the circulation was bad because of all the vessels that were cut, and my ankle was so swollen I couldn’t see the top of my shoe. But having to walk around and work made the other vessels take over and now there’s hardly any swelling.” She told me about her job, and her three schools, and what a kick it was to work with children again. I learned a lot about school nursing, and how different it is from what I imagined. She used to call and tell me about her days with the kids, and I knew there was another book in the making. Her job would have driven me crazy, but she loved it.

And so we went, for six years. She seemed fine, no problems, enjoying life. She finished her first book and found an agent and it got published, to her surprise as well as everyone else’s.

“It really is a book, it’s real.” She turned the little paperback over and over in her hands and smiled. “We did it, friend.”

Then., a few days later, the same week in May when her agent told her the second book about school nursing had been sold, she found the lump. She called me with the news of the big walnut-sized lymph node in her left groin, and the bottom fell out of her life.

“I was taking a bath, and my hand bumped into this thing, this lump. I lay there in the warm water for a minute, afraid to breathe. The Nurseperson inside said “OK, buddy, get out of the tub and go call the docs and let’s find out what this is” but the other person cowered. The water was warm, the day was warm, and I felt cold as if a harsh winter wind was blowing in the room. It was nearly thirty minutes before I could tell Jack, and another thirty before the Nurseperson took over and phoned the doc and made an appointment.”

Then they did the needle biopsy, which means they stuck a needle in the lymph node and drew out some fluid to check it under the microscope, and she and Jack waited some more. Waited to hear if it’s nothing, or Something. Then a few days later, the news came back positive for melanoma, and so they took a deep breath and made plans to have it taken out.

When all the tests were done and the surgery was scheduled, she sat up on the gurney wearing her gown and little shower cap. We were in the holding area near the Operating Room and she looked around and watched. I knew most of the nurses, so they let me put on a pair of scrubs and sit with her until it was time.

It was a big room, holding about a dozen gurneys in little alcoves, with curtains to go around, like an Emergency Room. There was a sense of calm purpose in that room; people in scrubs and little caps moved quietly around, starting IV’s, adjusting the flow through the tube, arranging blankets around their patients, as they all lay there waiting to go to surgery. There was a bright sort of look about the room; clean and spare. No nonsense, no doubts.

In one alcove across from us, they were getting an elderly lady ready for a total hip operation. She was in her nineties, at least, and lay there on the stretcher about as big as a ten year old kid. They had taken her dentures away for the surgery, and she lay murmuring quietly in a little lisp to herself. The nurse went up to her bed and said, “Can I call you Mary?” and the old lady looked at him for a long moment and replied, “No, I’m alone now.”

We both heard it, and Carolyn leaned toward me and said, “Peg, I really need for you to remember that. Tell Jack and he’ll put it in my journal at home. That’s really important.” I nodded, figuring that if writing in her head like collecting dust with a vacuum cleaner would keep her mind off her surgery and herself, it was OK with me. It would have been hard to forget that little old lady, anyway.

Carolyn sat up on the gurney and watched, and didn’t want to lie down. She was a nurse, and she had to stay alert and ready, right? She couldn’t lie down like a patient. The nurses in the OR laughed and said, “It’s OK, Fink, lie down and we’ll look after things.”

When they took her into the OR I went out into the waiting room where Jack was. We went for coffee and wandered around, and I watched to see if there was anything Carolyn would have wanted to remember. While we had coffee, Jack told me about the day they went for the CAT scan.

“It was like something out of a bad TV movie,” he said. “We had a flat tire on the freeway, and had to park the car and then run across two lanes of traffic to get back home for the other car. Here we were, sliding down dirt hills and arroyos, Carolyn in her sandals, racing to get home. There were several barbed wire fences we had to crawl through; you couldn’t lift them up high enough to get through easily.”

Jack shook his head, drank coffee and was silent for a minute. “We finally made it back home,” he said. “Carolyn dropped me by the car on the freeway, and drove like mad to get to the CAT scan. She was so tired by then she fell asleep on the X-ray table.”

The surgery took nearly three hours, and it was late when Carolyn woke up. She was in a bed up on the floor, with her leg elevated on pillows, and the first thing she said was, “It’s gone! That damn little lymph node with the tumor in it is gone.” We looked at her leg, wrapped in an Ace bandage, painted orange with Betadine, and at her little swollen toes.

“I’ve got to get up and walk. she said, “I can’t just lie here and not move.”

The operation had been done high up on her left leg removing three lymph nodes and the excision was quite long. She also had a tube going into the wound and a drain bottle taped to her leg. The drain removed fluid and kept it from building up in the tissues. We worked together to get her out of the bed, huffing and puffing.

“Gads, Fink, I’m glad you lost weight over the past year!” I said, lifting her off the bed so she could stand.

“Don’t let go; it’s like a flame thrower on my leg, Peg.” She closed her eyes until the flames subsided, and then took a deep breath. “Off we go, pal.”

We got as far as the bathroom, when Owen, the night nurse, came in and took over. Carolyn finally stopped being her own nurse and just relaxed and let Owen take care of her. He brought her some broth because she hadn’t eaten in twelve hours. He checked the drainage and made sure the pillows were under her knee. Jack and I left around 9PM, and she told me later that they had a very busy night on that floor. She wanted to get up and help. But she managed to get up to the bathroom by herself, and looked at the bandaged wound across the top of her leg, and told herself that tomorrow at home she would take the bandage off and look at the scars and count the drainage and change the bandages and be a nurse and a patient and write it all down.

The doctors recommended treatment with Interferon, and she chose to see Dr. Kazu, one of the oncologists at the UNM Cancer Center, where I worked and she had too, ten years before. Let me tell you about it.

The Cancer Center at UNM has several hallways, each one is a different clinic. Across the hall from the clinics are two waiting rooms, one for patients and their families to sit and wait, the other for patients to use educational materials and a computer with a program describing different kinds of cancer and their treatments. It’s a quiet place, carpeted, plants hang on the walls. The people who work there want to be there, and most of them have been working there for a long time. Some of the nicest people in the world work in that Cancer Center, and I know because I’ve been there for twenty-five years. I may not be one of the nicest, but one of the oldest!

Down the hall from the main clinic area is the Therapy Room, where Tracy, one of the other oncology nurses, and I hang out and do our thing. This is where we do the treatments, chemotherapy, antibiotics, all kinds of vitamin and hormonal therapy and of course patient education. Like the other corners of the Cancer Center, it’s a special place. It’s down the hall from the clinics, away from the hustle and bustle. Along the far wall are three recliners, with blankets folded at the feet. People sometimes get cold during their treatments, and we like to keep them warm. Years ago I made some macrame holders for pots, so we have plants and green things growing. We also have a bulletin board with cards and letters and notices from our patients. On the right is our Pharmacy, where Berta Kate hangs out and mixes medications and checks charts and keeps us organized. She was named for two Southern grandmothers, and we call her Kate. She works in a small room with a Dutch door where she puts medications and charts, and on the walls are bottles and supplies. Kate works at the corner desk on her computer, and on the other counter there’s a safety hood where she mixes chemotherapy. She has a collection of her family all around her, like we do at our desks. Pictures of kids, patients, grandparents, friends. We all seem to collect things, which makes the place look like house, or a den where people are comfortable.

There isn’t much noise in the therapy room; sometimes all you can hear is Tracy or me tapping the computer keys and the sound of the coke machine down the hall. Phones ring but not much; I guess the word for it is peaceful.

The day Carolyn and Jack came to the Center it was like a reunion. All the people she had worked with ten years ago crowded into the waiting room. Raffie from Medical Records and Jim from Nuclear medicine came, and Emily kept looking up and down the halls, waiting. She had worked with Carolyn years ago. There were smiles and hugs all around. Some of the smiles were forced because a recurring melanoma is no joke. I could tell that Carolyn was soaking up the warmth and good fellowship. It meant a lot to her that so many people remembered her and Jack.

“Come, my pretty, it’s into the dungeon with you!” I took her by the arm and took her down to the Therapy suite, where we had the prescriptions for her medication and the supplies she would need. I gave her a couple of books, too.

“Here, Fink; you worked here back in the Dark Ages, and things have changed, so read these. And don’t pretend you don’t have questions, either. Just ask!” She laughed and went down the hall to her appointment with Dr. Kazu.

He’s a man of Japanese origin, medium height, born and raised in the Northern Plains of the United States. His face is youthful and unlined, his black hair shot with gray. He is fit and compact and plays tennis every week. Around the walls of his office are plaques which are all the same, but with different years engraved on them. They are all awards for the best teacher at the University of New Mexico Medical School, and year after year Dr. Kazu was given these awards by the students. He is very proud of them, and glows when he teaches. He’s probably trained every oncologist in the city, and their success reflects on his teaching. Their success in medicine and also their empathy and intuition with their patients, which is harder to teach.

I left him with Jack and Carolyn, and knew that his fine intuition and vast knowledge would work for them as it had for many other patients over the years. They had made the right choice with Dr. Kazu.

About a half hour later I walked into the exam room with Carolyn’s records to talk to her and her husband about Interferon, and the insurance claims, and the side effects. Dr. Kazu was there, talking in his quiet voice about the cancer and the emotional side effects.

“You can get mad at God, that’s OK.” He smiled but his dark brown eyes were serious. “The most important thing in living with cancer is the closeness between people. That closeness comes in sharing feelings and communicating fear. What you need to remember is not to try and ‘protect’ each other. If Jack is angry and confused and scared, he needs to tell Carolyn. And Carolyn needs to tell Jack that she needs him. If you both try to protect the other one, you’ll each carry 100% of the burden. That way, you’ll be alone and isolated and you’ll make it all much worse.”

They nodded and looked at each other as if they had had this conversation before. Dr. Kazu stood up and smiled at them. “Let’s do this one day at a time. It’s too hard to live in six months intervals; no one can do that. And call me anytime, at home or here.” Dr. Kazu is slim and strong and quick, and he looked intently at Carolyn, who wasn’t known for asking for help. “Anytime, do you understand? I don’t care if it’s three in the morning, you call me if you need me.”

I sat down and we talked about the medication, and the side effects.

“It’ll make you very tired, some people also have flu-like symptoms, from mild to severe.” Carolyn made a face. “I know, it’s not easy and there’s a high drop out rate on this drug. It needs to be refrigerated, too, all the time. What you need to do is give yourself the injection in the evening, and then take a mild analgesic and go to bed.”

I thought of something I needed to say, to this contrary old buddy of mine. So I leaned forward and looked her straight in the eye, and said, “Remember, this medication is all we have to use against melanomas. Just remember that, and don’t beat yourself up because you can’t move mountains.”

She ignored me, and asked, “How long will I be on the Interferon?”

Dr. Kazu smiled. “About a year, probably. Maybe more. But we can discuss that later, and we can also adjust dosages to give you a good quality of life while you’re on it.” Dr. Kazu hesitated as if he had more to say. “I also have a job for you to do.” He leaned against the counter and smiled at the look on Carolyn’s face. Job? I knew what he was going to say but she wasn’t sure, so she said nothing and waited.

“With this disease and treatment, you need to do things you enjoy, things that make you feel valuable and productive. Peg tells me you’ve written a book. I want you to write another one, about the caring and community that goes on in the chemo room, and among patients in general.” He turned to me and said, “Peg will help with names and addresses and phone numbers of some of our patients, and she’ll explain to them what you’re doing. It’s very important to show how patients help each other, how they find solutions to problems and give each other tremendous support. We help, but we can’t do it all.”

Carolyn nodded slowly, looking at me and Dr. Kazu. Years ago, she had seen closeness and compassion in this place, among our patients. She had learned to watch, and compare notes with other nurses, and sit quietly with people in pain, listening. And now Dr. Kazu was giving her a gift; more access to his patients. She knew what it meant.

“I’ll start interviewing as soon as we get back from our trip,” she said.

This was a big trip, a very important one that had been planned for months. One of their sons was to be married in Kentucky, and after the wedding they had plans to take the train to New York to meet the editor of the first book and then take the train all the way across the country to see another daughter in Seattle, then to California where the newly married son would settle down, and then home to New Mexico. It was a long trip, three weeks long, and would be made more difficult because they had to take the Interferon with them in a cooler, and she still had the drain bottle attached to the healing wound in her leg.

I wondered if she knew what all this would involve? It would mean injections on a moving train, emptying and measuring the drain twice a day and keeping track of the fluid so she would know when to take it out as the drainage ceased. It would mean keeping everything clean so she wouldn’t infect herself. It would mean carrying a cooler around, making sure it had ice all the time, and the trip was scheduled for July. She would look like an alcoholic carrying beer around with her. But she thought of another problem.

“I’ll have to hang on to the prescription so no one thinks I’m a junkie doing dope with these needles and syringes!” she laughed. She laughed but it wasn’t funny. The doctors gave her the instructions she needed, and she promised to follow them.

“I don’t want to end up having to have this drain replaced in a strange town. We’ll do it,” she said with a grin. “I don’t know how, but we’ll do it.”

I went back to the therapy room and told Tracy what they were planning. She looked at me and shook her dark head.

“It’ll be a mess, and most people wouldn’t even attempt it, but she has to do what she needs to do. I just hope it all goes OK.”

It did, and she came back three weeks later looking good and feeling fit.

“It was a hassle but it was worth it,” she said. “We nearly lost the whole drain contraption around my leg while I was walking down the aisle, after the wedding.”

“What did you do about the bandages and the plastic bottle, in your mother of the groom dress?” Tracy asked.

“Cut one leg of the panty hose off, and acted like everything was fine.” Carolyn laughed. “What else could I have done?”

Weeks went by, she came in regularly to sit in the corner and write about the patients and how it felt in the therapy room. We do try to make it quiet for the patients, and it is kind of a special place. We work here every day, so we don’t always notice how special it is, but she did.

“It’s so quiet, so comforting,” she said. “When I worked here ten years ago the chemo room was in a hallway, with people in and out all the time. It’s different here, and I like it.”

“Come and meet Maryann,” I said and took Carolyn to the recliner in the back of the room. Maryann was 32 years old, mother of two small children, and had leukemia. She was also a poet.

“I’ve tried to put my feelings into the poem, but sometimes they slide off and won’t stay.” Maryann was a tall woman, dark eyes, and her hair had fallen out from the chemo and she refused to wear a wig.

“It scratches, and besides, it isn’t real. This is real.” She ran her hand over her bald scalp and smiled. “I do wear really outrageous earrings, though, when I go out.” She looked around the quiet therapy room, and smiled again. “This isn’t going out, this is coming home.”

She gave Carolyn a copy of a poem, and the two of them sat there and compared notes about writing and hurt and fear. I watched them talk, one sitting up in a recliner, bald and worn, and the other sitting on the stool next to her, not bald but gray. I don’t know who helped who, but something was happening, something good. When Carolyn stood up and collected her things, I walked her to the door. She looked past me, into middle distance, and there were tears in her eyes.

“Can I do this, Peg? Can I talk to patients and get it right, while I’m dealing with my own problems? Or will I start getting to be a bore, sounding like a broken record, full of fear and anxiety?”

“I don’t know, we’ll have to see if it happens. You weren’t a bore before, why start now?” I laughed but it sounded hollow, even to me. She smiled, a little smile. That was enough, for now.

As the weeks went by, we gave her names and phone numbers of some of the people we remembered, patients who had touched the lives of others, and she went to see them, and reported back.

“It’s the most amazing thing!” She put her satchel and notebook down and gave Tracy and me a hug. “It’s just amazing. I start a book about the caring that patients have for each other, and end up with a strong support system myself.”

She told us how a nurse in Australia had written to her about the first book, and how she wanted to be a part of the next one. That nurse had read about the book on the Internet, where Jack had put a web page and a contest to publicize it. Her son’s old roommate had a girlfriend who was a nurse in Massachusetts who loved the book, and so it now has ‘a fan club in Tewskbury’ of all places.

“They’re out there, hoping things go well, and praying for me. It’s the most wonderful feeling....” she shook her head and was quiet for a minute, looking around the chemo room, at the recliners with their hand made blankets and the plants hanging in the macramé. She peered into Kate’s little pharmacy and said hello, and then she said, “I had to be a nurse and writer first, and now a patient, to do this.” She shook her head and sighed. “Now I’ve got work to do.”

She took her notebook and sat down near Carmen, a woman with breast cancer, who had been listening to our conversation. Carmen had dark eyes and wore a white turban around her head.

“You mean you’re going to write about us?” she asked.

Carolyn nodded. “Yep. Did before, and will again.”

I went over to Carmen and adjusted the IV drip. “She’ll put everyone in it that she can catch so be careful what you say!”

The woman laughed, and said. “I haven’t got a special story, just the same old thing. Found a lump, had surgery and now I’m having chemo. It must get boring, hearing the same thing over and over.”

Carolyn took Carmen’s hand. “People are never boring, and the story is different every time, because it’s a different person. You’re special because you’re you, so your story is special, too. Tell me about it...how did you find the lump, and how did you feel?”

Slowly, Carmen told her story. It was sort of the same thing we had all heard before, the story that never was boring. She told about finding the lump in the shower, waiting for the biopsy results, agonizing over the decision of lumpectomy or mastectomy, wondering how much life there was left, looking at all the loved ones in the family with sharper, clearer eyes.

“There are things I had been putting off, like helping at my grandson’s school as a teacher’s aide, now I’m not putting it off anymore. This is a gift, you know.” Carmen’s eyes were shining. “Someone from Reach for Recovery told me that when they came to visit me in the hospital, and I didn’t believe her. I thought she was nuts. But she wasn’t, and I’ve told other people. I’ll tell you, and you write it down.”

She looked at Carolyn, and sure enough, she was busy writing it down.

“You need to go see Honoria,” I told her. “She’ll tell you about her experience. It’s really some story.”

Carolyn nodded and kept writing, and the little notebook filled up and she brought a bigger one. She came back often to linger in the chemo room with Tracy and me, and talk to the patients and absorb the feeling in the room. She wasn’t being treated here at the Cancer Center, she did her own injections at home, but we supplied the medication and the needles and syringes, and she felt close to us. Sometimes it was crowded in the therapy room, sometimes it was quiet, and she sat in the corner with her notebook and watched, and talked to patients, and followed Dr. Kazu around, and talked to Kate about her interaction with patients.

Kate laughed, her brown eyes crinkled, and her dimples danced.

“Tracy and Peg say I play nurse pretty well!” she said. “I thought going into Pharmacy would mean less contact with patients, but not here.”

“We get everyone involved around here,” I told Nancy. “Walk in the door, there’s a job to do. Too much for just Tracy and me.” I winked at Carolyn. “You get off because you’re working on your writing, but remember, you’re still a nurse. If you look bored, we’ll put you to work, too.”

It was time for our next patient’s treatment, so I told Carolyn to come with me to the waiting room to get Mr. Baca. She could see what goes on in there while I took him back to the therapy suite. The waiting room looked the same as it always did, people sitting around, drinking coffee from the big urn we kept there. Mr. Baca was sitting with his wife, holding his cane with his brown gnarled hands. Two people were looking at the educational materials we kept on the table, one was an elderly Hispanic man, another was a blond teenager. The teenager, whose name was Joshua, was explaining something, marking his place on the pamphlet with his finger. The old man was Carmen’s husband, waiting for her to finish her therapy. He turned to me and I introduced him to Carolyn. He shook her hand and patted the teenager on the arm.

“My English isn’t as good as his!” He smiled and nodded. “But he’s explaining things to me. He has to go slow because I can’t hear too well.”

The tall teenager grinned. “He reminds me of my grandfather, remember....” he turned to me and I nodded.

“I remember. It’s been a few years, but I remember.” His grandfather had been a patient here several years ago. Joshua came with his mother when they brought the old man in for therapy. He used to watch, wide-eyed, at all the equipment and supplies, and never said much. But a few years later, Joshua came back to volunteer and help with the supplies in the waiting room.

Carolyn nodded, taking in the scene. A young boy about ten years old, Carmen’s grandson, sat with a toddler on his lap. His big brown eyes watched every move we made, just like Joshua years before. The toddler squirmed, and slid off the child’s lap. Mr. Baca smiled at the toddler and the teenager, and stood up slowly, wincing and holding his cane tight.

“Old bones,” he said. “Old bones and your medicine!” He followed me back to the therapy room, walking slowly but steadily, letting the cane support him. I left Carolyn in the waiting room, among the people she needed to get to know.

She would write the stories, hers and all the others, and we would tell some of them, and she would find more. And the waiting room would fill up with patients and their families, and empty and fill again. The waiting room would always fill up again.