How is it that we as oncology social workers have chosen to sit with people in such uncertainty and pain? It is hard to go through life without eventually being confronted with suffering, with illness, with fear…. yet life also brings us deep beauty, moments of peace, awe, joy and warm connections with others. People often comment that they don’t know how we do the work we do. Why would we choose to, day in and day out, sit with people in such a difficult place? Yet over the years I have seen that these two sides of life are not mutually exclusive; they often seem to be intertwined, moment by moment. 

This work has shifted in me over the years. There are always so many new theories and techniques to learn in our desire to bring more to the people we work with. I have loved attending conferences, hearing wisdom and being inspired by fellow social workers as we discuss and learn better ways to meet the needs of our clients. I am so grateful for those who are doing research, who are sharing their clinical expertise and what they have learned through their own studies and their work with others. And I have also enjoyed the rich discussions when attending sessions where we delve into the spiritual side of life and practice, which is interwoven throughout. 

I have always loved what psychologist Dr. Carl Rodgers said: Learn your theories well, then put them aside when you confront the mystery of a living soul. The theories are critical, the learning is rich, inspiring and thought provoking, yet we are invited to sit with our clients fully present, focusing on them and what is arising in them as well as ourselves, trusting that the theories will guide and sustain us at a deeper level.

Working in the field of oncology invites us to touch more deeply into our own mortality and the seeming randomness and uncertainty of life. It can be unnerving. The thought that we are immune from suffering becomes less plausible. Some of the times I most treasure are times when I am sitting with someone in pain and we explore thoughts of meaning, the “why’s?” the mystery, the moments when in the midst of struggle there is a glimmer of peace. Some clients may frame these thoughts through the lens of their faith tradition, others may be struggling with existential questions and issues. Some are angry with God and feel abandoned and let down, others cling more to their faith and find it to be a lifeline. This is not a time for answers, but for creating a safe space where clients can open up and look at some of their deepest fears and questions. Periodically we have organized retreats and spirituality workshops to provide a more directed time of spiritual exploration and discussion as well. 

Frequently, when our clinical team gathers for weekly supervision, I start by inviting us to sit quietly for a few minutes, and we take turns leading a brief meditation or breathing exercise. In addition to being a good way to start the meeting, it helps all to feel more comfortable and confident doing this with clients or groups. One colleague with whom I led an evening group always called me off to a quiet space to sit for about 10-15 minutes before the group started. As the silence deepened, we became more settled and the busyness of the day would slip to the background. It created an openness and a way to be present for these people living with stage 4 cancer, allowing our own agendas and “theories” to take a back seat.

Ram Dass once said: We are all just walking each other home. We are part of this amazing mix of humanity. We have chosen to sit with people during a very critical and sometimes pivotal time in their lives. We are all just as vulnerable, just as human, just as unknowing. We are all in this together.