These are the things that Karin Paredes, a medical assistant at UCSF/John Muir Cancer Center, can no longer do for her chemotherapy patients, the small lovely gifts she gave that Covid-19 has taken:
“I cannot hug them when they are crying, (a lot of them cry when they are new patients; they cry and say, ‘Why is this happening to me?’). I always console them, but now I cannot massage their feet or rub their shoulders. They can’t see my beautiful smile and my dimples, cause my face is all covered up.”
She sighs, then says ruefully, “I try to make my eyes expressive, and I reassure them by saying, ‘You are in the right place with the right people taking care of you.’
When I take their vital signs, I weigh them and I ask: you want to know the number? Some don’t want to know if their weight is too low.
I offer warm blankets, pillows, drinks. I make jokes when I bring water or juice: ‘You want this tequila neat, or maybe a Prosecco instead?‘
I notice their body language, and if someone can’t stop crying, then I advocate to their doctor, ‘PLEASE I really think this patient needs a family member in. Please make an exception.’ Then, if the provider agrees, I set up the room for safe distancing.”
Karin’s bright eyes light up when she describes her work.
One thing she does for her patients that she especially loves is to wrap their hair in the Dignicap Scalp Cooling system, to keep their hair from falling out. This preserves (freezes) the follicle cells and stops damage during chemo. “It’s soooo cold, and the patients shiver in the beginning. But when I see the hair growing back, I call them my babies, ‘Look, the hair is coming back.’”
She laughs, “I never have any men who ask for this treatment; I guess they don’t care if their hair falls out.”
She has been at the UCSF Helen Diller Comprehensive Cancer Treatment Center at Mission-Bay for seven years, and this last year, during the pandemic, she has been working at the UCSF East Bay site in Emeryville.
In covid times, patients cannot bring a family member or friend with them into the treatment room. They go through the infusions alone.
“Now we have computers with cameras in the room we set up for them to talk to their families. It’s hard on them, so I try to make them laugh: I leave the bell with them — ‘Call me for excellent room service,’ I say.”
Karin, 41, came here from Peru in 1995 to join her father. She left her country because the terrorist group, Sendero Luminoso, was pressuring young people to join the organization, (”La Revolucion,” they called it.)
She worked in restaurant kitchens (Il Fornaio, Pier 23, The Bohemian Club) and had her own house-cleaning business while studying English at City College. As her English improved, she took courses in medical terminology and medical interpreting.
Along the way, her father went back to Peru in 2004, (his hand was damaged in an accident at his dishwashing job), she brought her sister and nieces up from Peru and supported them through her sister’s escape from domestic violence (2005-06), then married and divorced and had a son, Michael, who is now 11.
Through all the ups and downs, through all life’s vicissitudes, she doggedly kept attending City College. “I go to school, faithful, in the mornings, and work in the afternoon and nights. Or other way around, depend on job.”
After getting her medical assistant certification, she was hired as a temp at UCSF’s Pediatric Cancer Center, on probation, for a three month tryout.
“My son was turning four when I got that job, and that job changed me. I went to three funerals in the first six months and I cried a lot. In one year, so many kids died. Liver cancer and pancreatic cancer; that’s the worst one, pancreatic cancer, they turn green, I never see that in my life, a child with green color. I took care of one 14-year-old boy, he came with his parents from Shanghai, and even though I could not speak Chinese, he called me his girlfriend and I called him my boyfriend, we joked and teased. I learned to manage; I never cried in front of the patients, only in the bathroom. ”
When she was offered a transfer to UCSF’s adult cancer treatment center at Mission Bay, she accepted gratefully and has felt, ever since, “This is the place I am supposed to work. This is my right place.”
But nothing could prepare her for the unique and peculiar challenges of performing her job in covid times.
“ I tell you, I sometimes feel like I have to be an FBI agent.”
That’s because, early last year, she was faced with a patient lying about being positive for covid.
Karin was unprepared. “ So, this Latina patient, she did not look good, she looked rundown and tired and we are walking into the room and I said what happened, she told me she needs the doctor to look at her throat, WHY YOUR THROAT, you are here for your chemo, I thought, RED FLAG RED FLAG. SO I find out she lied downstairs at the lobby, (where the screeners ask about symptoms and exposure before patients come up for treatment) but when I talked to her friendly, cozy, in Spanish, she told me her niece has covid from work, and she lives with her, WHAT I SAY, WHAT? AND YOU FEEL SICK NOW?”
Karin shakes her head, “We sent her to the ER for a test and it came back positive so I had to quarantine at home for four days! It was so stressful. Lucky I did not lose my pay; we now have vacation hours, sick hours, and “Covid 19 hours” for our timesheets.”
In the last year, there have been several such incidents, where patients deliberately or accidentally, have hidden their covid status,
“So the craziest thing, one patient was a nurse, so this is funny, she is a nurse from another hospital, coming to see her oncologist at UCSF, and she suspected she was exposed and she did her test so the results goes into mychart, (electronic medical records) and it popped up as we were getting her into her room, and again they told me to go home and do the test if its negative come back to work. I went home, called the hotline, and got my test. They ask how long were you with the patient, I was there with the patient only six minutes. I was very fortunate to have the right tools: my mask, my shield, my gloves, I feel safe and protected by my job.
But STILL I was nervous, it’s unbelievable, I did not have my son for two days until I got my negative results. In the last year, I lost two family members to covid. But Thanks God, I never got sick, I never tested positive. But I have taken so many tests, my poor nose hurts.”
She pauses, and then says in a rush,
“You know, covid or not, I LOVE MY JOB. My family in Peru is so proud of me; I am the first one to become a professional and work in a hospital, they say I am a nurse, I TELL THEM NO, NO, NO I AM JUST A MEDICAL ASSISTANT but my goal is to become an oncology nurse. Sometimes I do things that are not my job to do; I do the extraordinary because people need it. I do not have the power to cure their cancer, but I do have the power to make them feel safer while they are going through it. “