Bell Ringing and Other Cancer Celebrations

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work, Emeritus

OCTOBER 29, 2018

How Do Public Cancer Celebrations Make You Feel?

Many cancer treatment centers have a ritual that is sometimes beloved and sometimes detested: When someone completes prescribed cancer treatment, s/he is invited to ring a large bell that hangs in the Infusion Center or, sometimes, in the lobby. This is similar to radiation treatment areas that shower patients with confetti (pink for breast cancer patients) as they exit the treatment room after the final radiation blast.

Understanding that I take the risk of being viewed as cranky or worse, I hate these activities. I am sure that there are some people who feel joyful and celebratory when the final chemotherapy needle is removed or they stand up for the final time from the radiation table. There are more people, however, who feel glad to be done, yes, but hardly celebratory at the same moment. Instead, they wrestle with a complicated mixture of feelings that include exhaustion, anxiety about the future, relief, sadness to be leaving caregivers who have become close, and general uncertainty of what life is going to be post cancer. Hopefully everyone also feels some pride in what they have accomplished, but that is rarely the primary feeling.

Even more importantly, I worry about all the people who are being treated for advanced/metastatic/recurrent cancer. They are probably going to be on one or another treatment for the rest of their lives. How do you think they feel when the staff is congratulating someone with an earlier stage version of their illness while they are trying to stay alive? A friend, knowing my feelings, sent me a good essay about all of this from Medscape

Here is one quote from that article that confounds me: At a prominent cancer center in New York, there is a large "victory bell" in the main lobby. "You can hear it throughout the first four floors of our main clinical building, and it's such a happy surprise," said Beth Lenegan, PhD, director of pastoral care at the center. In a comment that is representative of many centers, she added: "Everyone who hears the bell stops what they're doing, smiles, and applauds."

Really? They applaud? Do they also applaud the man with Stage IV lung cancer who is struggling to walk down the hall for his next chemotherapy? Do they applaud for the parents of the child with leukemia who has just learned that a hard-earned remission has ended? Do they applaud for the woman with Stage IV breast cancer who has just lost her hair for the umpteenth time? You catch my drift.

My strong suspicion is that this tradition was begun by someone who has never had cancer. Whether it was a clinician or an administrator or someone from Marketing, the tin ear towards cancer patients is pretty obvious. All of us know that no one who has not been through cancer can truly understand what we have done and what we are feeling. That is equally true for all challenging life experiences, You can’t, for example, really understand what divorce feels like unless you have been through it. But others don’t ordinarily plan so-called celebratory moments for divorcing couples.

There is something about cancer that seems to attract public attention. Many of my patients have talked about the amazing chutzpah that some people demonstrate toward their wigs or scarves or very short growing-in hair. Who gave them permission to touch our heads? Or even to make comments? Another life experience that often includes such public intrusion is pregnancy when strangers pat our bellies and remark on our changing bodies and lives. I, and most others, didn’t like it then, and I didn’t like it again during cancer.

At the BIDMC Cancer Center, there isn’t a bell to ring or confetti to be thrown. What we have, instead, is respect and empathy and endless hope. I much prefer those sentiments to an invitation to beat the gong.

How do you feel about public celebrations and cancer? Tell us in the BIDMC Cancer Community at http://www.cancercommunity,