The theory that Kagan builds up from elders stories should replace popular assumptions about waging an all-consuming war against cancer or an identity of older people as primarily old rather than as individuals shaped by their life experiences. Clinicians who base their approach on popular constructions of what it means to be old and have cancer will offer less-than-satisfying care to patients they fundamentally just dont get. Many of the students and staff nurses Kagan works with, though, have picked up on her research and by-example leadership.
Anna Beeber GNu00 who is working through the Ph.D. program, has been mentored by Kagan as a HUP staff nurse and through her M.S.N. studies. When most of the other students wanted to enter hot specialties like obstetrics and critical care, Kagan helped the young nurse come out of the closet regarding her interest in geriatrics. I never knew what it meant to be a nurse until I met her, says Beeber, who recalls working with Kagan and an old man with a stubborn bedsore. While the apparent problem for this patient was wound-management, I began to realize that the nursing required was so much more than wound-care. We were evaluating the patients response to his illness, discussing his general views about life and feelings about death, and, most importantly, focusing on relieving his suffering. We were not there to treat the problem, but instead to learn about the patient and learn from the patient. With this information, we could then create a personalized plan of care.
Kagans compassionate skill and expertise in gero-oncology have been sought at the bedsides of patients, in consultation rooms with medical teams, in classrooms of nursing students, and in big lecture halls as keynote speaker in Hong Kong, Sweden, England, and elsewhere. Her students and HUPs ward nurses all speak of her brilliance and unflagging generosity. In 1996, Kagan was the winner of HUPs Nursing Excellence Award, and she was recognized for distinguished teaching with a Lindback Award in 1996. Margaret Crighton Nu94 GNu01, another of Kagans Ph.D. students and a former HUP nurse, reports that Kagan has helped change for the better how many of the nurses practice there. They will take that with them wherever they go, Crighton says. Everyone admires her.
Harold Blooms notion of genius is not a hairy monster. A literary critic who holds up Shakespeare as the supreme genius, he offers his own personal definition. Because of Shakespeare, he writes, we see what otherwise we could not see. One litmus-test that readers should pose to ascertain whether they have encountered literary genius is, he says,Has my awareness been intensified, my consciousness widened and clarified?
Its ironic that Kagan should, in some sense, be recognized for what the medical and nursing establishments already know deep down: that the individual person is the center of care, that older adults suffer most from cancer and that, therefore, we ought to be listening to them. Its the human relationships that matter most. And yet its these basic and obvious truths that seem hardest to put into practice in our fraying health-care system.
Sarah has the mark of a true mentor, says Crighton. She sees in her students what they cant see themselves, [and] she has an uncanny way of getting people to see things in a totally new light. The MacArthur Foundation, it seems, is intent on disseminating a little of that light.
Kagan studies and cares for some of societys most fragile members, a population that rarely makes headlines as the subject of scientific breakthroughs. Nor are these patients the customary first choice of nurses and physicians delivering patient care, notes Strumpf. Old people with cancer are not cute and charming and tragic like little kids with cancer, says Kagan, but she finds something deeply satisfying in working with frail elders who over and over again display the fortitude to transcend ineluctable pain and go on living.
Grave illnesses challenge people to dig within themselves and reflect on the lives theyve led and try to use what theyve learned, says Kagan. How they respond varies from individual to individual, but I think that as a result, I get to hear a lot of great storiesI get to know a lot of people in times that are very, very trying for them but which create opportunity and a sense of triumph. People tend to display the best in themselves when they feel as though theyve accomplished something they believed was impossible. That achievement can be anything from going back to work to caring for a grandchild through profound chemo fatigue or simply sitting up in bed after an arduous recovery from major surgery. Sometimes it means facing death, when it can no longer be pushed back by modern medicine. Its not big science and high technologyits listening to patients, one story at a time, that can transform health care.
Kagan looks into the face of pain, decline, and deathand all the wounds of the human conditionand she doesnt blink. She even finds joy there. We may be weird, but were worth it, she once told Beeber, encouraging the young nurses love of caring for the faded blooms.
What Ive learned is that each persons sense of suffering is unjudgable, Kagan says, and being able to help people past that moment of suffering can be incredibly rewardingthe joy that you share with someone who says, My pain is half of what it was last night, and I feel sooooo much better. Thank you.
Peter Nichols CGS93 is the editor of Penn Arts & Sciences.
page > > >
page > > >