The power of small gestures - Graham Lamb

Graham Lamb, Cook Team Manager at The Christie

Graham Lamb

Small gestures can make a big difference - a simple smile and a thank you go a long way. As a member of the catering team at The Christie, we know this only too well, and will always go the extra mile to help our patients. 

What we do is a very important part of the patient experience, but working in a place where everyone has been touched by cancer can be even more rewarding.

That’s one of the reasons why The Christie has set up a serious of monthly meetings for its staff to discuss their feelings and to share their experiences. These meetings are called Schwartz Rounds and I was delighted to have been asked to give a presentation at one recently. The theme of the discussion was the ‘The Power of Small Gestures’. 

At first I struggled to think about what I should speak about. But then I started to think about what we in the catering department actually do on a day-to-day basis and how our department makes a difference to patients, visitors and staff. We do some pretty impressive things and we also understand the power of small gestures.

Every day we come to work and do our jobs but never take the time to appreciate how much hard work, care and dedication we put in, and it is only by reflecting on and talking about it through the Schwartz Rounds that we have the chance to stop and do that, which is quite an eye opening thing to do, and is also very cathartic.

Most people don’t realise how often we are asked to visit patients on the wards when they have specific dietary requirements, or because their treatments or personal preferences mean they can’t always find meals to suit their palate. We often tailor menus to suit individual patients and revisit them every couple of days to plan the meals for the following period. Simply by doing this we find patients are more open to discussing their meals and in some cases, when their preferences may seem a little strange, they feel more comfortable  speaking to us rather than the ward staff because often they haven’t considered the possibility that we can provide alternative choices outside of the standard menu.

Through visiting a ward we get to see a patient over a period of time. It’s very rewarding to see a noticeable improvement in a patient , especially those who are eating properly again through our input. The flip side of this is that it can be very upsetting in a small number of cases to see a patient continue to deteriorate, despite the best efforts of all the doctors and nurses, and of course our own team that works so hard to find choices of food that the patient will want to eat.

Simply by discussing and planning their meals with us, patients feel included and empowered and are more inclined to try and eat their meal because they have had an input into it. 

Through communicating, encouraging and involving the patients we know that we go the extra mile to offer the best service. It is always appreciated by the patients and when they say “thank you”, that gesture always makes what we do worthwhile, no matter how tiring the day has been, we focus on that gesture.

One example of how the catering team has gone the extra mile for patients was when a very poorly patient in the last days of life wanted to get married. We got a call at 11am that morning to say the wedding was taking place at lunchtime and could we provide a wedding buffet, including a wedding cake, to be served at 1pm. How could we refuse a request like that! 

So we pulled together as a team with all the usual mayhem going on around us and managed to deliver a wedding buffet as well as a cake with chocolate balloons, hearts and the couples’ names iced onto the cake. 

Knowing that we had done something so special for someone in their dying days was hugely rewarding and we know that most patients really appreciate that. It’s equally rewarding when the efforts we go to are recognised by our colleagues with a simple thank you – the power of small gestures really can make a big difference, but are all too easily overlooked!

Most people only see the ward service or the restaurant service and don’t appreciate what goes on behind the scenes to ensure those services are delivered on time. For example we serve around 1,500 meals per day to patients and staff, all freshly prepared and cooked on the premises. No microwave meals like a lot of hospitals serve to patients! It’s essential that we send the patient trolleys out to the wards on time and ensure the restaurant service is set up and ready to go each day. We often have buffets to do for meetings and the odd wedding breakfast to provide as well, so team work is essential.

So our days can be interspersed with ups and downs, positive and negative gestures, however, as always, a positive gesture from a patient cancels out anything negative about the day, making our jobs even more worthwhile, and giving us a great deal of job satisfaction. Working at The Christie and helping our patients really is a special experience. 

The Christie is like a jigsaw and we all make up that jigsaw, no matter what job we do. We all form part of that jigsaw and if any piece is missing, the jigsaw can never be completed. Each piece of the jigsaw is also like one of those small gestures, and without the thousands of small gestures everyday, our Christie jigsaw would be incomplete! 

The Maggie’s centre is a one stop shop of support run by professionals offering practical and emotional support - Louise Hassall

Louise Hassall, Christie patient and Maggie’s volunteer

Louise Hassall

In 2010, at the age of 37, I was diagnosed with cervical cancer. Nothing can prepare you for what is about to happen to you, your family and your friends both physically and psychologically.

Sometimes all I want is to sit in a calm and friendly environment with people that understand and maybe not even talk about cancer, but to know others around me feel some or the same emotions that I do.

I also want to know that my loved ones have the opportunity to seek refuge in a place that is comfortable, safe and with people who will understand. Often these services are available but can be scattered around and are not always easily accessible at a time when they are required. 

When I found out that a new centre called Maggie’s would be opening I was intrigued as to how this would complement the already great services that The Christie offer. I wanted to know how this would impact me and other patients and how my loved ones may benefit too.

I was therefore excited to be given the opportunity back in the winter to learn more about Maggie’s, meet the centre manager Sinead Collins and see the new building that was just last week opened by Her Royal Highness the Duchess of Cornwall.

On a bitterly cold and rainy Manchester day I met with Sinead, the centre manager, donned work boots, gloves, a high visibility vest, glasses and a hard hat and was taken to see the building in progress. Sinead explained each room and how the finished building would look.

Despite the weather and the unfinished rooms I could already feel the calm and peace that this building holds with much of this down to the thoughtful layout and space. The long area through the centre of the building, and the ability to see an exit or the outside no matter where you are, put me at ease and added to the feeling of being relaxed and calm.

With warming fires and a big kitchen table to encourage a meeting place for those dropping in, it will certainly make for a welcoming experience from the moment you walk through the door.  

The centre is a one stop shop of support run by professionals offering practical and emotional support without the need for an appointment, which is important as you can’t always predict when and what support you need, and in my experience if you aren’t able to get the help immediately you often don’t go back.

I felt like it was a haven away from the hospital despite being a stone’s throw away and a great space to go by yourself or with those who you are with, to just sit with a cup of tea.

I couldn’t help but compare my needs throughout the last six years and the services that will be on offer at the Maggie’s Centre.

In the past my husband and I have come out of appointments often having heard bad news and we’ve had nowhere other than a public waiting area, corridor or the car to digest the information - and that can add to your distress. The opportunity to now have somewhere to go that is on the grounds of the hospital will be a huge help and make a big difference.

During the hours of waiting between appointments and chemotherapy where a patient wanders around the hospital or the local area, I and others will be available at the Maggie’s centre to discuss nutrition or to take a class on managing stress, creative writing or an exercise class such as yoga, tai chi or walking. Being able to take your time drinking tea or just sitting serenely without the time constraints you can feel in a café or other public place will add to an improved sense of calmness, and for those who love gardening or find it therapeutic, there is a garden to enjoy and the opportunity to help tend it.

Importantly, the service is available to anyone affected with cancer at any stage, and this includes family and friends who will be made to feel welcome and their emotional needs met too. During many of my operations and procedures my husband pounded the streets of Didsbury, but now he will now have the option to go to Maggie’s where he can chat to others in a warm and welcoming environment and benefit from the services on offer. Knowing that this is available to him already makes me feel better. I believe that the cancer journey can be harder on those supporting you, so Maggie’s will be peace of mind to me and an additional support network to Steve.

The Christie is an excellent hospital, with fantastic staff that do a brilliant job at offering support and services, but the addition of the Maggie’s Centre will add value to my experience and wellbeing as a patient and to all patients, so I am looking forward to using the centre and offering my time to help as a volunteer.

I’ve really valued the emotional support from everyone around me, especially the team at The Christie - Katie Stephenson

Katie Stephenson – Parotid Gland Cancer Patient (Mammary Analogue Secretory Carcinoma)

Katie Stephenson

I’m 30 years old and November 2015 marks four years since I began treatment for parotid gland cancer. 

I live in Chorley, Lancashire and I work in Public Relations for the NHS. I remember the moment I found my first tumour like it was yesterday. It was July 2011 and I was having a lovely lunch in a beer garden in Lancaster (fish and chips if you were wondering!) when I felt a lump on my jaw. Always the hypochondriac, I dramatically said to my friend, "feel this lump, it must be a tumour!"

The lump didn’t go away and after weeks of poking and prodding by various doctors and a few courses of antibiotics in case it was a cyst, I had an ultrasound. I’d done a lot of research by this point and pretty much knew every eventual outcome so when he told me it was a solid mass I was as prepared as I could be to hear that news. After a fine needle aspiration, which basically meant a doctor stuck a tiny needle into the lump and drew some fluid from it to test, the results were inconclusive so I was delivered the news that I’d need a major operation to the side of my face to remove the lump (most likely a tumour) and half of my parotid gland. 

The parotid is part of a family of three salivary glands and it sits just below your ear. Again, I’d done my research and found that salivary gland cancer is rare with approximately 550 cases being diagnosed each year, most commonly in people over 50. The exact cause of this cancer is unknown and in most cases, tumours in salivary glands are benign. 

With any surgery there were also side effects and with mine these included facial paralysis, numbness and problems with the salivary function. Although these were worrying to me, I was only 26 at the time so my main concern was about the gigantic scar I’d have running down my face.

I had my surgery done in Preston and I cried the first time I looked in a mirror. I’m not an overly vain person (my friends might correct me on this!) but I had 40 stitches down the side of my ear and down my neck, a huge dent in my face where part of the gland had been removed and little to no movement in half of my lip. 

Katie post surgery

Despite this I waited patiently for the results of the tests…..I waited and I waited….20 weeks later I was delivered the news that it was a malignant tumour however it had been removed with clear margins which meant that they believed they had got it all. The reason for the delay was that it was a newly described tumour and not many labs had seen one before. Eventually I was given its definitive name; Mammary Analogue Secretory Carcinoma.

Almost a year to the day of finding the original lump, I found, and had removed a second tumour. Luckily this one was a lot closer to the surface and the surgery was nowhere near as invasive. At the same time as this surgery I received Botox injections to my face as I’d developed a relatively rare side effect of the surgery known as Frey’s Syndrome. This is basically a mutation of your salivary glands so instead of your mouth watering on the inside, I was getting a moist cheek – not a good look when you’re stood in front of a tasty buffet and your cheek starts watering!

Following the removal of the second tumour I was referred to The Christie to discuss my treatment options. As it was a relatively recently named tumour there was some uncertainty as to what the treatment should be. At the initial consultation we discussed the different options available to me; further surgery to remove the rest of the gland or a course of radiotherapy, both of which carried further risks and complications. In the end we decided that I would be a “watch and wait” patient, meaning I’d have scans and check-ups instead of treatment. 

This course of action didn’t initially sit well with me. I’d really struggled emotionally during the wait for my initial results and I didn’t think I had the strength and resilience to do it again, but with the support of my consultant we decided to go ahead. I now have bi-annual MRIs to my head and neck and I visit The Christie four times a year for check-ups. I won’t lie, sometimes it’s really hard to just sit back and wait. I check the area every day and I’m just waiting for the time I feel another lump. I did have a scare last year but thankfully it was just scar tissue from my original surgery on the move.

Throughout my experience I decided to document this by blogging (www.apainintheparotid.wordpress.com). I struggled to find a lot of UK based information about the condition so thought I’d share my experiences with anyone else who was going through this too. I post pictures, tips and updates and I find writing about my day, hospital appointments, scar progress (and the occasional whinge) extremely therapeutic.

I’ve also really valued the emotional support from everyone around me, especially the team at The Christie – shout out to Professor Slevin! Whilst I might not be having visible treatment, people should never underestimate the emotional impact a cancer diagnosis can have and the compassion and care from the team at The Christie has been second to none.

After my surgery I was left scarred, unable to smile on one side of my face and feeling very self-conscious. I became extremely anxious and pretty much ate my feelings, putting on over six stone in weight in the process. Over the last 18 months I have really seen an improvement emotionally, and finally managed to get some focus back in my life. I even went back to university to study for a postgraduate qualification, something I could not have imagined doing three years ago. 

If I was to give one piece of advice to anyone reading this who is going through something similar, it would be to never underestimate the power of emotional support. I know all too well how easy it is to retreat and want to deal with it on your own, but please just talk to someone. I’m a very independent person and leaning on others for support didn’t come easily to me but I learnt that this doesn’t make you any less strong or unable to cope and, without that support, I wouldn’t be the person I am today. I have a much brighter outlook on life, my confidence is coming back and I’ve started to shift some of the weight that I’d put on. I’m still a way from eventual discharge (pending no new lumps – fingers crossed!) and visiting The Christie has just become part of my life routine, but without the fantastic support of the team at The Christie, my friends and my family I don’t think I would have come through this so strongly.