Ringing-bell-twoAs pancreatic cancer patient Verolga Nix-Allen walked slowly through the waiting room of Radiation Oncology in the Perelman Center – flanked by her son and daughter – the room erupted with clapping, smiles, and tears. Wearing a graduation cap and gown, she arrived at a large bell and pulled its cord sharply. The sound rang out.

In other departments, this might be an unusual event but not here. This celebration happens, on average, 10 times a week and it’s always for good reason: It signifies that the patient has completed radiation treatments.

Office supervisor Chris Hartman has seen many variations of the ringing. Some are low key -– a patient comes with one or two family members -– while others are much more elaborate. For example, Nix-Allen held a special celebration -- with many well-wishers -- during which her choir sang “I’m a Survivor,” a composition she had written. Another patient “belonged to a motorcycle club and they all came!” Hartman said. “People bring balloons, roses…. It’s incredible.”

“It helps people mark a successful completion but also recognizes that just making it through the weeks of treatment is an achievement,” said Theresa Myers, BSN, RN, OCN, nurse manager. “It’s hard to come here, every day, for weeks, getting radiation and coping with side effects. Patients watch others cross the finish line and look forward to when it’s their turn.”

Hugs for the patient are a big part of all ringings -- from family members and friends, other patients, and staff. “We all get to know each other well. There’s a great deal of camaraderie,” Hartman said. Indeed, patients who have finished treatment will often come back to say hi during follow-up visits or to witness other patients they’ve befriended ring the bell.

Ending treatment is bittersweet, said patient John Day, who recently completed treatment. “I’m excited Bell-ringing that I’m done but I’ll miss the radiation team who made the treatments so much easier, the other patients in the waiting room, the front desk staff…. So many great people.”

Ringing the bell wasn’t always a part of radiation treatment at Penn. When patient Frank McKee came for treatment in 2011, “your treatment ended and that was it. It was such an empty feeling. Your whole life changes during treatment. You become a part of a community … and then it’s over.”

After hearing about another proton center that used a bell to recognize completion, he decided this was exactly what Penn needed. A lifelong sailor, he donated the bell from his own boat. It took a while to put the bell into action (it was so big, it required HUP’s carpentry shop to build a stand to hold it!) but by 2012, the ritual was on its way to becoming a tradition.

And not only outpatients get to ring the bell. “We’ll wheel patients out on a stretcher if they want to ring the bell,” Hartman said. There is also a handheld bell for those who cannot make it out to the main lobby.

One person, who heard a ringing when he arrived for a family member’s first radiation treatment, explained its impact in a letter. On exiting the elevator leading to Radiation Oncology, “we found a large group of people clapping and cheering. Not the atmosphere we were expecting.… It was memorable, as I type I am tearing and will probably have some difficulty reading this out loud…. There is a bonding going on, very positive in nature, always a nod or a smile, never a negative feel.… I have seen about five or six now and each time I’m elated to the point that I may be leaning a little more optimistically.”

“The bell ringing is truly a rite of passage for these patients who endure so much to fight their cancer,” said Amy Avellino, MS, RN, director of Nursing in Radiation Oncology. She recently brought a group of “seasoned clinicians” on a tour of the department. Ending the tour in the main waiting room, the group was able to witness a bell ringing. “The group I was with all stopped and gazed at the display of triumph and joy on the gentleman’s face with his family taking pictures. When the bell actually rang and the entire room yelled out with cheers, there was not a dry eye in the house.” 

Why a Bell?

A plaque on the bell stand explains HUP’s bell ringing tradition:

“Bell Ringers”

As the sailing ships of another generation relied on their ship’s bell to signal their position in the fog, may this bell enable you who ring it to navigate your way through life free of cancer.


Photo captions:

(Top photo) Verolga Nix-Allen finished her radiation treatments by ringing the bell and celebrating with family and friends.

(Bottom photo) Patient John Day was excited on his last day of treatment but will miss "so many great people."

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