Cancer Screening in Action by Vince Pepe

Ring. Ring. “Hey Vince! Can I get some help with interpreting?” said one of our providers.

“Of course! I’ll be right over!” I said as I hopped up from my chair to head over to the nurse’s station. Most of my days at the clinic are spent at my desk in the administrative wing sifting through patient charts to find who is due for breast, colon, or cervical cancer screenings. However, my daily task is mixed in with calls from providers who ask me to interpret for their Hispanic patients. 

As I met the provider at the nurse’s station, she explained to me that the patient is new here and was in for a quick physical. The encounter was running smoothly as expected, but the patient did have one question about her weight. She was concerned that she was losing too much weight without trying. The provider tried to calm her nerves by letting her know that her increasingly busy schedule, which caused her to skip meals, was probably causing her minor weight loss.

The provider’s response seemed to only superficially relieve her. When I asked again if she had any additional questions, she responded with tears. She revealed that she had a lump in her breast for a while now, but as a busy mother, she did not have the time or money to have it checked out. Upon examination, the provider found the breast had a darkened, textured spot along with a swollen axillary lymph node. This peau d’orange or “orange peel” skin and the enlarged lymph node I later learned are classic signs of breast cancer. From the clinic she drove herself directly to the emergency department as directed for an immediate mammogram.

As I walked back to my desk, I began to rethink the mentality I developed over my service term. Working indirectly behind a computer monitor and telephone, I have struggled at times to recognize and value my effect on the patient population. Many times I have asked myself if my calls even make a difference or if I am truly helping anyone. As a soon-to-be first year medical student, I admire the providers at my clinic, who are able to directly care for their patients, and I yearn to be in their positions. They were the ones actually helping people I thought. However, this encounter demonstrated the significant impact I am making right now as a volunteer. Lack of access to health resources is one of the biggest pitfalls of the US healthcare system, and care navigators like me help keep busy, fearful, or uninformed patients proactive and engaged in their health management. My daily calls could be helping our other female patients catch breast cancer before it progresses like the aforementioned patient. The same can be said for colon and cervical cancer. I know it’ll still be a few more years before I can start practicing medicine; however, even in my current role, I am still able to make a difference today.