Vicky Viel Temperley reawakes the spirit of creativity and humanity among cancer patients, their caregivers, and medical personnel, transforming the hospital experience into a one that nurtures and supports patients during some of the most challenging periods of their lives.
La idea nueva
While her son battled cancer, Vicky became shocked by the inadequacies of the Argentine health system in dealing with the psychological trauma caused by the disease. Recognizing that a patient’s emotional state could determine if he/she withstood or abandoned treatment, Vicky crafted a holistic treatment model for cancer patients that revolutionizes the patient experience. Chemotherapy thus becomes entwined with a wholly humanitarian approach. By integrating therapeutic and physical care, she ensures that patients and their families can have creative and psychologically fulfilling treatments. Cancer patients and their families who participate in Vicky’s program Donde Quiero Estar (Where I Want to Be) at public hospitals in Buenos Aires can take classes in creative or relaxing activities in the midst of their actual chemotherapy. All activities serve to divert their attention away from the pain of chemotherapy and help them rediscover their sense of creativity and humanity. This reinvigorates their will and persistence to continue their treatment.
The hospital institution itself transforms into a nurturing space for cancer patients through Vicky’s work. She identifies all the resources and manpower in the facility and converts it into the standard-bearers and allies for Donde quiero estar, from the oncologists to the maintenance crew. Everyone can join the classes and activities that the patients experience. This redefines the hospital as a place that cultivates a support network and a sense of solidarity; thereby reducing or eliminating the loneliness and isolation from which many patients suffer during chemotherapy. It also reconnects doctors with their patients on a deeper, more personal level that becomes crucial in helping them to regain trust and improve their patients’ well-being.
The program blossoms organically within each hospital, based on the enthusiasm of the medial professionals and the needs and wishes of the patients and their families. By giving everyone a feeling that they are vital elements of the system, Vicky has created many fans and ambassadors of the program who wish to implement it in other oncology clinics. Vicky piloted her program in Argentina’s best and biggest teaching hospital, the Hospital of Clinics at the University of Buenos Aires, and she has now built partnerships in other hospitals as well, with the hope to reach national and even international prominence.
A diagnosis of cancer can be emotionally traumatic for individuals and their families, but nearly as painful is the treatment of the disease. As they undergo chemotherapy, patients’ endure incapacitating physical side effects such as vomiting, hair loss, weight loss, and low energy levels, sometimes to such an extent that they abandon treatment. Just as significant are the psychological effects; cancer patients will commonly grow discouraged, lose their zeal for life and develop a negative self-image. They also grapple with recurring fears of mortality, requiring their arduous effort to remain optimistic and prevent these thoughts from dominating their lives. The austere and uninviting hospitals and clinics make the treatment experience even more unsettling and desensitizing for the patients, who yearn to reconnect with their humanity, creativity, and healthy previous lifestyles. In the face of their loved ones’ suffering and debilitation, patients’ family and friends feel powerless to support and encourage them to continue with their treatment. They will also grow weary and despondent, thus producing a general aura around the hospital of hopelessness and pain that does not buoy the patient’s recovery.
The doctors, oncologists, and nurses also struggle with their patients’ pain, but their stern medical treatment styles often inhibits them from connecting on a personal level. To protect themselves emotionally, doctors often treat patients as clinical cases rather than as individuals with feelings and pain. Their technical medical education does not include training in empathy and the emotional skills to help cope with the difficult situations they face. In Argentina, where doctors are especially overworked and underpaid, they are often stressed and cannot focus their attention on any one patient, thus further deteriorating the doctor-patient relationship. Yet the doctors and nurses are some of the most important and influential individuals in the patient’s life during treatment, so a cold and distant relationship only aggravates the patient’s sense of isolation.
The incidence of cancer in Argentina is alarmingly high: over 150,000 cases are detected per day, and some 150 people die every day from disease or accompanying complications. Because of the very personal nature of this type of cancer, patients with breast cancer especially suffer from sensations of dehumanization and loss of identity during their treatment. Yet rather than support and comfort patients of this and other tragic variations of the disease, the medical system in Argentina and beyond treats the patient as a nameless case that accelerates his/her emotional and physical decline.
Aware that cancer affects the entire family and medical institution that surrounds the patient, Vicky developed Donde quiero estar, a complementary approach to medical care that increases patients’ psychological well-being. Because their well-being is closely linked with the general ambiance of their surroundings, she has developed a series of activities and tools that respond to the needs of cancer patients, their families, the medical caregivers, and external volunteers alike. Her plan integrates each actor in a distinct way to ensure that the program functions smoothly and everyone participants in tandem, thereby producing a powerful support network.
Vicky’s approach is simple yet effective. From the time a patient is admitted to the hospital and begins chemotherapy, Vicky’s team intervenes. First they engage all family members and friends involved in care and support to understand the patient’s medical condition and emotional state. These initial conversations generate a sense of trust between the caregivers and the Donde quiero estar team. Then every time patients go to the hospital to undergo treatment, they can choose to participate in painting and photography classes or receive massages or reflexology services. These activities serve various purposes. On the one hand, by being administered while the patients are receiving the chemotherapy dose, they help cancer patients cope with the treatment by taking their attention away from the physical pain. Vicky and a team of university researchers have for example documented a decrease in nausea and vomiting as a result of these interventions. The personal care and photography workshops play an important role in raising the self-image of patients. By engaging in creative and relaxing activities, the patients’ focus shifts and helps to change the atmosphere in the room.
On the other hand, the program serves as a tool to establish strong personal, non-clinical bonds among everyone else involved in the patients’ care—doctors, nurses, family members, and volunteers. To this end, Vicky has also developed a program entitled, “Supporting those who support others” for doctors and nurses to reconnect with their own bodies and relax their physical and mental states through massage therapy among others. This helps to increase their own general well-being and self-awareness, translating into better patient care. Beyond the activities offered during the chemotherapy sessions, Vicky also offers workshops open to all members of the hospital community, including yoga, aerobics, dance, and arts and crafts. In addition, the doctors often participate in the painting and photography workshops directly with their patients thus giving them more opportunities to interact and form relationships beyond the clinical level. As a result, the hospital environment becomes warmer, calmer, and conducive to friendlier doctor-patient relations.
About fifty-three loyal, trained volunteers help organize and execute many of the activities and add external, non-technical value to the support system. These volunteers are often family members or even former cancer patients so enchanted by the model that they return in a different fashion, expressing empathy with the current patients. Vicky has developed partnerships with schools and citizen organizations to attract other volunteers who can offer support to the medical personnel, families, and patients. Moreover, she has developed strategic partnerships with provider organizations that supply trained professionals to teach the creative activities. For example, she is working with a number of institutes from the School of Californian Massage, Counselors from the Private Institute of Spiritual Consulting and the Nuevo Caminos Foundation (NCF), among others, to bring advanced techniques into her clinics.
To raise wider awareness of her work, Vicky has been running a painting contest to showcase the artwork produced by patients and doctors. The contest serves as an important source of motivation for the patients and their families, and many return after their treatment ends or return to the hospital while they are in remission, specifically to help as volunteers. The results of the contest are broadcast around Buenos Aires through media, gaining more visibility for the work. Other medical groups and volunteers have specifically expressed interest in adopting a Donde Quiero Estar model in their hospitals after the contest.
Vicky has allowed the program to grow organically and freely, with an open source-type strategy that allows for all volunteers and participants to add new elements and activities that might be valuable in their respective facilities. Having drafted a basic manual of activities, she can deliver to new interested initiatives a guide that serves as a basis upon which their own programs can arise. She first started at the Hospital of Clinics teaching institution at the renowned University of Buenos Aires, where she could capture the next generation of doctors. This raised the credibility and visibility of Vicky’s program and facilitated its expansion elsewhere. By spreading the manual and the techniques openly, she has managed to maintain flexibility among distinct Donde quiero estar initiatives and attract others to her proven model.
Vicky estimates that about 1,500 patients a year pass through Donde quiero estar, but her deep, life-changing impact on their assorted family members, medical caregivers, and volunteers is far greater. Numerous participants report a drastic shift in their loved ones’ attitudes from despair to confidence. Now everyone who has experienced the program has become a passionate devotee and ambassador to bring new volunteers on board and spread to other clinics.
Vicky has in the past two years spread from the Hospital of Clinics to a hospital in Tigre, in the Province of Buenos Aires, through her alliance with the Nuevos Caminos Foundation. She is now working to spread the program to at least six hospitals in the larger area in the short-term while also identifying opportunities throughout Argentina. The hospital administrators, oncologists, and volunteers have become her leading champions and change agents, helping to replicate the program in two other hospitals. Vicky also recently signed a major agreement with the Ministry of Health in Buenos Aires to replicate the program initially in four public hospitals in Buenos Aires.
For years, Vicky worked as a birth companion. She specialized in maternal psychoprophylaxis and worked extensively with women who suffer from psychiatric issues during their pregnancies. This professional training, her deep commitment to the social sector and the tragic loss of her father, brother, and son to cancer, together influenced her as she began to design Donde quiero estar. As her son battled leukemia at age 15, Vicky witnessed him lose confidence in himself and his purpose in life. Medical professionals too, she recognized, suffered as a result of their patients’ pain. If she could help him cope with his fear and anxiety by re-sparking his creativity and engaging the healthy parts of his body, the pain would become more tolerable for him, her family, and the doctors.
In the midst of her son’s treatment, Vicky began to look for spaces that would allow her to alleviate her pain and transform it into constructive experiences. She then sought to pass on this type of support to those undergoing similar situations. After her son passed away, Vicky created and led a group of parents in mourning, worked in psychiatric institutions as a companion to patients in rehabilitation, and coordinated support groups for people suffering from severe addictions. Vicky drew on these experiences while she has pieced together Donde quiero estar.
Vicky is relentless and absolutely convinced that her approach can and will achieve a high social impact. Completely committed to her vision, she has tenaciously not even allowed the heartbreaking recent death of her husband, also to cancer, to stand in her way as she builds a comprehensive psychological program that she intends to see executed in all the hospitals and cancer wards in Argentina.