Do you remember your high school superlative? Although we may not like to admit it, at one point in our lives we all shared a not-so-secret desire to be acknowledged by our peers in the school yearbook. Melanie Thomas, RT(R)(T), the clinical lead for the radiation oncology department at Seby B. Jones Regional Cancer Center in Boone, NC, was appropriately identified in the West Wilkes High School annual as Ms. Dependable.
At first glance, it is her purple scrubs and bedazzled shoes that are hard to miss in-and-around the treatment room, also known as the vault at the Cancer Center. But, it is her warm smile, infectious laughter and joy-filled heart that allows her patients to feel at ease during their treatment.
Hymns of grace
Thomas was born just down the mountain in Millers Creek, NC. It was there that she learned how to hang with her brother on the ball field, appreciate a front porch conversation and sing with all-of-her heart in the church choir.
“Our church was located right next door to the house I grew up in,” she said with a grin. “As I got older I served as both the junior choir leader and the youth play director. I believe that time in my life taught me about leadership, patience and grace, a whole lot of grace.”
Thomas also appreciated the sermons she received at home. “My parents both worked long hours and multiple jobs to provide for our family. They taught us that trust is earned and that your word is your bond.”
Her interest in medicine developed as a result of her father’s involvement in emergency management services and the local fire department. “Dad was always rushing off to help people when they needed it most. I guess in my own way I wanted to follow in his footsteps.”
After high school she went to Asheville-Buncombe Technical Community College to study radiology where she met a radiation therapist who inspired her to pursue a career in radiation oncology. From there she went on to Forsyth Technical Community College to complete her radiation therapy training which required an onsite clinical rotation. The one-week rotation, which Thomas completed at Seby B. Jones Regional Cancer Center, turned out to be more of a working job interview than a school requirement. After graduation, she was hired by the Cancer Center and is now approaching her 14th year of service.
Grapes of peace
As the clinical lead for the radiation oncology department, Thomas works closely with the radiation oncologist (doctor), physicist, dosimetrist and her team of fellow radiation therapists, otherwise referred to as “the grapes” because of their purple uniform color, to provide treatment for their patients.
First-time patients typically start out in the simulator room. It is there that Thomas determines the patient’s exact body position and measurements for treatment. For head and neck patients, this process also involves the creation of a form-fitting facemask that each patient must wear to hold their head steady while undergoing radiation therapy. To help ease the thought of this unnatural process for patients, Thomas shares that she and all of the other grapes have each made their own facemasks and that it is a painless experience. She then uses the Cancer Center’s 16-slice CT machine, which is specifically designed for radiation therapy, to take 3D x-ray images of the patient. From there, the radiation oncologist contours (analyzes) the patient’s CT images frame-by-frame to determine which areas of the body to treat with radiation. Once the dosimetry (radiation plan) is put in place, Thomas schedules the patient’s next treatment appointment.
“Patients are typically overwhelmed during their first visit,” she said. “I remember working with one lady who just wanted to have a safe place to confide her tears. All she said was that she did not want to cry in front of her husband, that she wanted to be strong for him, so, I did my best to be strong for her.”
The Cancer Center also offers a wide variety of survivorship programs.
During treatment appointments, the grapes are the only ones that can actually operate the linear accelerator and “beam on” the radiation. Each patient is escorted into the treatment room and carefully repositioned on the table as they were on simulation day. After all questions are answered and the patient selects their preferred music choice on the iPad, the radiation therapy begins. Thanks to recent upgrades to the linear accelerator, the length of time required for most treatment procedures has been reduced from an average of 15 to 30 minutes to an average of five to seven minutes.
At the conclusion of each patient’s six to eight weeks of radiation treatment, the therapy team celebrates the momentous occasion in a unique way. “We all gather around the patient and cheer as they strike the Cancer Center’s ceremonial gong to signal the end of their treatment.”
“People often ask me how I can do what I do?” she said. “Although we want all of our patients to have a good curative outcome, the sad truth is that some patients come to us for palliative (pain management) end-of-life care.”
Thomas shoulders the burden of compassion fatigue on her 40 minute drive to-and-from work each day. “In the mornings as I drive up the mountain I pray for each one of my patients.” she said. “And on the way home, I thank God for the family that I get to return home to, the family He knit together.”
Unable to have children of their own, Thomas and her husband are fostering and in the process of adopting an 18-month-old boy and his 10-year-old brother from a group foster home. After hearing the case, the couple went through a grueling year-long “emotional rollercoaster” in order to keep the brothers together.
“I’m so thankful for my family both at the Cancer Center and at home,” she said. “I have so much love to give and I pray that my patients and my family can receive that from me.”
On Sunday mornings, Mrs. Dependable can still be found singing in the choir of the church she grew up in. “I have so many reasons to be grateful,” she said. “I can’t help but make a joyful noise.”
The new mom has also recently started taking online classes to complete her bachelor’s degree in Radiological Services at East Tennessee State University. Her family is very proud.
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For more information about the Seby B. Jones Regional Cancer Center in Boone, NC, a member of Appalachian Regional Healthcare System, visit apprhs.org.