The Forrest for the Trees: A jacket for Danielle Cass

There are two tiny jackets in The Walking Gallery.  One belongs to my son Isaac, he wears a boy’s size six.  The other jacket belongs to the energetic Danielle Cass.  Danielle works at Kaiser Permanente and she is a manager for the national public relations, media outreach and communications for KP.  Her jacket is tiny, a women’s size small with baby doll sleeves.  It almost looks like a jacket for a little girl.  I understand exactly why Danielle chose this jacket for this painting.  You see inside, Danielle is still a little girl with two wonderful parents.  And those wonderful parents have both been diagnosed with cancer.

Danielle’s parents are retired physicians who dedicated their careers to practicing in public hospitals, conducting health research, focusing on health education to the public and teaching residency programs.

In this picture Danielle’s parents hold her newborn son in the year 2000, before they were diagnosed with cancer.

Her dad is a urologist and introduced mobile lithotripsy to the Midwest.  He was diagnosed with bladder cancer in 2002.  He has endured many surgeries, but still his cancer spreads and his treatment continues, with one complication after another.

Her mother, a family practitioner, opened the first health center for women in the United States in the mid-1980’s.  She also lectured widely about women's health.  Four years ago Danielle’s mother was diagnosed with melanoma skin cancer and advanced lymphoma.  These are two separate non-related cancers, yet she must be treated for both.  Danielle’ mother went through intense chemo, lost her hair, and the lymphoma went into remission. She continues on chemo every two months, and each month has more of her skin removed because of the cancerous lesions.

Danielle’s parents are on a path.  They are on a journey in the deepest forest of cancer care.  All of their years as providers can only help so much for now they are the patients.  Now they are stuck in a non-EMR supported non-integrated health care system.  They are scared and lost deep in the health care forest.  They are bewildered because the multiple providers who engage with them during their journey can’t seem to see the forest for the trees.

In this painting, Danielle’s parents stare into each other’s eyes.  Their gaze encompasses their deep love that spans decades.   But within this love there is also worry and confusion.  It feels as if within a moment they will walk arm in arm, supporting each other on that darkened path with its confusing signs and poorly lit corridors.  Unless you are a patient or have intimately cared for one, it is hard to understand how very scary and disempowering the patient’s journey can really be.

Before them is the forest and each tree is festooned with signs that tell them where to go next.  But often the instructions are contradictory and confusing.  Danielle’s parents find themselves going one way then another without any kind of healthcare GPS to lead the way.

Yes, I understand why Danielle picked this jacket.  She would like to remember a time when her parents were giants, and she was so small.  But that time has passed and the road is long.  It is Danielle’s time to listen to her parents distress and help them in anyway she can.  And she will do it and she will remember.  That experience will inform her life and her job, and help Kaiser Permanente and other health care systems see the forest and the trees.

A Post Script: Six Months Later

This is Danielle with her parents.  She had a chance to show them the jacket in person for the first time.  They were very moved especially when Danielle told them she had worn it on stage.



She wore her jacket at the Social Media Conference at the Mayo Clinic.  She stood out among a the crowd, but there were other walkers there to support.  Both Dave DeBronkart and David Harlow were walking as well.

She wore it again at HealthCamp LA, where she and Mark Scrimshire  led a group through their first unconference.  As they amazed the crowd with the wonderful immersion of open communication that the unconference model affords, they never turned their back on those assembled.  When you where a Walking Gallery jacket you are always face to face, whether it is with Danielle or with her parents.