The Compassion Gene

She’s smart, kind, caring, generous and humorous, and, oh yes, she totally inherited the “fashion gene.” She’s a snappy dresser who lives to visit consignment shops and refuses to pay full price for clothes. She could probably make a better living as a personal shopper than she does as a genetic counselor!

Cindy Trawick, RN, ANP, has been an awesome staff nurse for years, most recently in the post-anesthesia care unit and operating room settings. She went back to school and became a nurse practitioner, which is how she ended up working in our outpatient cancer center.

Here are some things that I have learned from her since she moved into the office next to mine: She’s from Georgia; I’m from Boston, Massachusetts. We both have funny accents, depending on who you ask. We have learned not to talk about sports or politics. We both love dogs and the great state of Maine. She is young and on the way up in her career. I am old and have calculated the days until my retirement in many inaccurate ways, but I know that it is sooner rather than later!

^{From left: Cindy Trawick, RN, ANP, and Sandy Allten, RN, OCN, CCRP. Photos by Kelly Robinson.}

Here’s what else I have learned: With genetic sequencing and testing becoming so crucial to treatments in oncology, there is more need than ever for a patient to have this procedure done. The problem: In the United States today, there is a shortage of certified genetic counselors (master’s prepared in genetics), which is expected to last another 10 years or so. Nurses or nurse practitioners who take the accelerated City of Hope genetics courses are respected for their practice, and they have been approved to provide counseling to patients who receive genetic testing by most insurance companies.

A lot of folks in the health industry feel that as long as you draw the blood or send the tumor tissue specimen off for testing, you can just have someone read off the results when the patient returns for a visit. It’s like reading the scrunched-up type on the side effects section stuck to the box of Tylenol. Who wants to read all that? Who will remember it two minutes later?

Or you can have a phone call or Skype message appointment to explain some of the results. During a call, it is hard to assess the eyes of a patient rolling back in their head as they fall asleep or veer off into a place of total confusion. A conversation like that may be classified under the umbrella of genetic counseling, but I’ve seen what an excellent version of this consists of, and that is not it.

Many patients are scared of the whole topic of genetics. They are afraid of what it means for them and their families. They skip appointments out of fear. They worry about possible extra costs. It is a complicated topic that they do not understand.

I hear Cindy every day (the walls between us are thin!) and have noticed her kindness and gentleness in explaining this very complicated topic to her patients. When multiple genetic aberrations were found in families, I have even heard her pray with patients when asked. I have seen her tears of relief when someone tests negative for a particularly deleterious genetic mutation.

For some professionals, genetic counseling would be done in an appointment or two. Cindy has taken many of her patients and their families under her loving wing and remains in their lives as a true counselor, resource person and loving nurse long after her sessions with them. For those who require further surgery based on genetic results, Cindy has been known to stop by the hospital to see how they are doing.

A genetic counselor visiting a beloved patient at time of entry to hospice? Yes, she has done that, too. She treats the patients and their families with love and support no matter where they are in the care spectrum.

She has taught all of us about some of the intricacies of genetic testing and counseling, but mainly, what she reminds us is that “counseling” is not a benign word or simply a 60-minute billable session. Counseling involves a sometimes lengthy process until the patient truly understands and accepts the information. Once that happens, that lengthy process can begin all over again with a different family member.

For us, our counselor Cindy is a gift. She can be the bearer of bad or good news, but she always gives the news with compassion and empathy.

I am proud of our organization for realizing the extra components she brings to the job. I love that they recognize that there is a difference between a voice on the phone and a caring face delivering complex information. I love knowing that our patients are in her excellent hands every day.

I love knowing that, besides inheriting the fashion gene, she also inherited the compassion gene!