Linda McCarthy

For CURE’s inaugural Metastatic Breast Cancer Heroes™ awards, I would like to respect- fully nominate Dr. Maria Raquel Nunes, a breast medical oncologist at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, as well as assistant professor of oncology for The Johns Hopkins University School of Medicine.

Dr. Maria Raquel Nunes. Photos by Will Reintzell.

Beyond her impressive and well-deserved medical and academic credentials, Dr. Nunes is widely revered by patients and colleagues alike for her boundless warmth, empathy and kindness. And that smile. We all love that reassuring smile.

It was her smile that first greeted me during my initial appointment in 2017. Having recently received a diagnosis of metastatic breast cancer, I had traveled 75 miles to Sibley from my mountainside home to be seen by Dr. Nunes. With her smile, I was immediately swept up in a calming and liberating wave of optimism.

As I soon learned, that wonderful smile is an outward manifestation of Dr. Nunes’ innate sense of purpose. And Dr. Nunes’ purpose is to always do the best by her patients.

Deeply embodied in Dr. Nunes’ sense of purpose is a desire to actively involve those patients in discussions and decisions representing a broad range of treatment possibilities. No false hopes. No magical cures. Just the latest and greatest in available options, grounded in solid science and research, both of which Dr. Nunes enjoys and fosters.

During these conversations, Dr. Nunes invites questions as well as candid, even differing viewpoints. The resulting free-flowing dialogue between patient and practitioner is as enlightening as it is encouraging.

Who knew that metastatic breast cancer could be effectively stabilized without the horror show that often accompanies raw chemo? I didn’t until Dr. Nunes originally proposed an oral drug regimen. When the effectiveness of one of the drugs ultimately waned, she recommended that I enroll in a Hopkins-affiliated clinical trial. Here, I have remained for over two years.

Thankfully, the retooling is working; during my last visit, heady medical terms like “awesome” and “beautiful” were used to describe results of the obligatory CT scan and labs. As if this alone weren’t cause for celebration, the scan also revealed the offending tumor was “smaller.”

Needless to say, there were smiles all around in exam room 4 that day, with Dr. Nunes leading the pack.

Dr. Nunes’ sincere desire to engage her patients in every aspect of their care isn’t limited to purely clinical queries.

At the start of this past January’s visit, she sensed an undercurrent of despair, reminiscent of my first Sibley visit. Even with my face shielded in a mandatory COVID-19 mask, Dr. Nunes realized something was very wrong. Putting the results of the morning’s labs on momentary hold, she paused from the routine portion of the visit to find out just what was troubling me so.

“My sister died from cancer yesterday,” I blurted out. “She fought hard for seven years, but it wasn’t enough.”

Then I proceeded to soak that annoying mask in a torrent of tears.

Dr. Nunes, who must see her share of distraught and despairing patients with cancer, pulled as close to me as polite social distancing would allow and began to listen intently as I recounted memories of my sister and her endless zest for life.

Kate had an extraordinary singing voice, was an accomplished fiddler and was studying opera, even as cancer was consuming her lungs. She was a true believer in music’s power to lift lives and souls, and her beloved fiddle will be raffled to raise funds for educational music programs.

All this I unloaded on the gracious and giving Dr. Nunes, who had never met Kate.

When I finally finished, Dr. Nunes peered over her mask and reflected on the loss of my talented sister and her courageous struggle. How she must have touched so many people. How her music must have been so special.

Then Dr. Nunes looked directly into my teary eyes, reaching past the grief to remind me that my sister wouldn’t want me to abandon my own cancer battle — an admonition Kate had quietly proffered, the last time I saw her, two months before she died.

Throughout these past four years, there has been any number of instances when I came away from an appointment believing Dr. Nunes was the most compassionate and dedicated doctor ever to don a white coat. True to her innate sense of purpose, Dr. Nunes’ genuine concern for my medical and personal well-being was never more on display than it was that dreary January afternoon.

All the while, a merciless global pandemic continued to subject health care heroes like Dr. Nunes to unrelenting mental, emotional and physical challenges.

I am truly grateful for everything Dr. Nunes has done for me since beginning my cancer journey. “Awesome” and “beautiful” test results. The incredible, shrinking tumor. A sympathetic ear when it was needed the most. Heartfelt words of support and consolation to go along with that sympathetic ear.

Oh, and her smile. I’ll always be grateful for her reassuring smile.

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Articles

A patient with metastatic breast cancer honors her medical oncologist, Dr. Maria Raquel Nunes, for her calming and optimistic approach.

The Power a Cancer Doctor’s Reassuring Smile Holds

® 2021 Extraordinary Healer Award®, I respectfully nominate Hayden Chae, B.S.N., RN, OCN, ME, Johns Hopkins Sibley Memorial Hospital senior oncology research nurse extraordinaire at Johns Hopkins Kimmel Cancer Center at Sibley Memoria Hospital in Washington, D.C., or as I've lately dubbed him, my “rainbow connection.”

Since June 2019, I have been enrolled in a clinical trial at Sibley Memorial Hospital that combines oral Ibrance (Palbociclib) with Faslodex (fulvestrant) injections. So far, I'm responding well to the treatment regime. Compared to other protocols, this one isn't so bad with the exception of the intramuscular injections. These monthly bolts to the buttocks must be given simultaneously by two skilled and sympathetic nurses. Adding to the fanny follies: the intramuscular injections are administered slowly, usually requiring up to two minutes before the derriere deed is done. That would be the longest 120 seconds in the history of time calculation. Yes, the shots can be a bit painful. How best to cope as the caboose is juiced? Why, go to a happy place, of course.

Recently, my happy place consists of singing silently to myself, Kermit the Frog's lyrical Muppet missive, "The Rainbow Connection." I have no idea why this particular song first wormed its way into my brain while dueling syringes were being emptied into my butt. I'm just glad and grateful it did.

Certainly, the melody is a welcome distraction as the Faslodex flows. More importantly, the refrain has become a metaphor for this phase of my cancer journey and the rainbow of extraordinary health care heroes who are making it possible. Hayden is one of those heroes.

Shepherding participants through a drug trial has to be demanding during the best of times. Factor in the unrelenting COVID-19 pandemic and the reality that I live 75 miles from Sibley Memorial Hospital, keeping my participation in the life-saving program on track must present its own unique set of challenges for Hayden, who helps to ensure the required labs, scans and doctor’s appointments can be performed at Sibley Memorial Hospital in a single day. He also cheerfully calls me after a visit just to make sure I'm doing alright, coordinates with outside providers for lab work or scans if killer viruses or wicked weather limits travel to Sibley Memorial Hospital. He also untangles administrative kinks I can't always address because I live so far away and patiently deals with a myriad of details like securing a gurney for the double-barrel bum assault (simply leaning over and grabbing a chair doesn't cut it, trust me.).

Each of these tasks Hayden deftly and eagerly accomplishes with his inherent good nature, unflagging determination and deep concern for the welfare of his patients, never permitting the clinical to outpace the caring.

I'm blessed to have an incredible treatment team, embodying a wide spectrum of compassionate and skilled medical professionals. Just like a rainbow spectrum, their boldness and brightness offer the promise of a new day filled with endless possibilities.

Editor’s Note: This is an essay submitted by Linda McCarthy for the 2021 Extraordinary Healer Award. 

 to read more about CURE®’s Extraordinary Healer® Award for Oncology Nursing event on April 30, 2021.

A patient describes the connection that she has with a senior research nurse at the institution where she has been enrolled in a clinical trial since 2019.

‘Rainbow of Extraordinary Health Care Heroes’ in Oncology Nurses

From left: Linda McCarthy and Jennie Tarica, M.S.N., RN, CN-BN - PHOTOS BY BOB RIVES

Since being diagnosed with metastatic breast cancer earlier this year, I’ve learned that compassion can take many forms. Certainly, there are the heartfelt sentiments, expressed as news of the devastating diagnosis sinks in, and the empathy shared when treatments often rival the disease in discomfort, distress and discombobulation of the daily routine that many now label your “new reality.”

Encountering this new reality, patients, their families and caregivers routinely find themselves battling not only the disease but also the often convoluted and confusing administrative infrastructure designed to aid a patient’s recovery.

Although well-intended, this medical matrix isn’t always well-organized, so patients genuinely appreciate that there is knowledgeable, compassionate help available. The difficulty often lies in accessing and utilizing these various avenues of assistance quickly and effectively. More often than not, the process requires a seasoned professional to serve as cheerleader and champion.

Many of us at Sibley Memorial Hospital are blessed to have Jennie Tarica, breast cancer nurse navigator, to see us through our medical matrix. For nearly a decade, Jennie has offered patients and their families her own brand of compassion, reassurance, empathy and expertise.

One of my first encounters with Jennie, as I tried to emotionally absorb my new reality, was a cheerful phone call. Her topic: gardening.

On the mountainside where I live, the arable soil was long ago supplanted by rock — hardened, unforgiving terrain that only heavy machinery can reasonably penetrate. Additionally, gardening was never a favored pastime of mine, because it usually meant weeding row after row of country corn and pole beans. When it came to creating personal moments of Zen, gardening definitely lost out.

Still, it was extremely kind of Jennie to include it in a welcoming conversation that, mercifully, didn’t focus on a dreaded disease.

Yet, in a flash of serendipity, Jennie did introduce me to gardening’s calming aura: She’s instrumental in maintaining the garden in front of Sibley’s entrance. Jennie eagerly volunteers her time, tending to an array of plant life. Her sunflowers, especially, seem to reach through the vast windows of the hospital lobby, spreading comfort to those of us seated on the benches, waiting for the next blood draw or trip to the infusion room.

Where Jennie ultimately found a larger connection as I waged war on my new reality was horses. Turns out we’re both incurable equine groupies. We traded stories about our favorite hay burners and the fun times we enjoyed with them over the years.

Our discussions about the venerated animal led me to seek out what I’ve taken to calling my “spirit horse.” His name is Cesar, and he lives on a farm near my home. I bring him carrots (the old boy will roll you for a carrot) and just visit — no riding, because all those cancer-fighting drugs can render bones susceptible to snaps and cracks. Cesar and I just hang out, sharing carrots and a few nose rubs.

It was those horsey conversations and email exchanges with Jennie that encouraged me to look past the illness, pull on a pair of faded jeans, grab a bag of carrots and introduce myself to Cesar. From then on, I knew I had a friend in Cesar — and in Jennie.

Since that time, Jennie has befriended me in ways that require patience, enlightenment, professionalism and a sizable dose of civility bordering on saintliness. It stems from her extraordinary ability to unravel the mystery of the medical matrix.

We each have our own stories associated with prescriptions, insurance requirements and doctors’ directives, and how they can all congeal into one gigantic mess. Jennie is totally unfazed by the medical madness. Guided by her inherent cheerfulness, she remains a stalwart advocate, confronting the matrix on behalf of her patients.

I personally have benefited from her remarkable talent. At the top of my list: an endless stream of billing and insurance issues. Complicating things more is the fact that I live 75 miles from Sibley, hiding on that unforgiving mountain. Thank goodness for emails, faxes, phones and a very facilitating Jennie.

Where has Jennie’s matrix-managing ability aided me most? That would be in applying for financial aid to help cover the out-of-pocket expenses stemming from lifesaving chemo drugs. You know the ones: Their actual monthly cost rivals the gross domestic product of a small nation.

Trolling the internet, I found several organizations that help with killer copays. These groups understandably require an incredible amount of information. Some of it the patient or caregiver supplies; some of it the medical provider supplies — on application forms that aren’t always structured well, with instructions that aren’t always clear, to be relayed on fax machines that can be decidedly temperamental.

With Jennie’s invaluable assistance and dogged perseverance, I was able to secure much-needed funding to help offset the cost of chemotherapy drugs — modern marvels that have me composing and typing this essay.

I soon learned that such pro-patient activism is typical for Jennie. She routinely supports fundraisers for various breast cancer-related charities. It’s not unusual to find her at an event, decked out in pink and pressing the case for cash and a cure. Jennie also helped design post-mastectomy surgery bags filled with an assortment of recovery-related items for appreciative patients and their caregivers.

Jennie’s creative energies also reach into the managerial ranks: She developed and supervised Sibley’s first oncology inpatient unit. Additionally, Jennie became an education and training specialist, focusing on oncology and pain management.

Whatever her undertakings, Jennie’s first priority is her patients and how she can help them successfully navigate the medical matrix. Those of us fortunate enough to have Jennie as our matrix navigator will always remember how she aided our recovery, redefining our “new reality” in terms more reflective of life’s promise and potential and less about the dire and dismal.

For these reasons, Cesar the Spirit Horse and I respectfully nominate Jennie Tarica for the 2018 

® Extraordinary Healer® Award for Oncology Nursing.

An Extraordinary Healer essay honoring JENNIE TARICA, M.S.N., RN, CN-BN [SIBLEY MEMORIAL HOSPITAL, JOHNS HOPKINS MEDICINE, WASHINGTON, D.C.]

Linda McCarthy

The Power a Cancer Doctor’s Reassuring Smile Holds

‘Rainbow of Extraordinary Health Care Heroes’ in Oncology Nurses

Master of the Medical Matrix

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