It’s a bright and breezy Wednesday morning in University City, Philadelphia as Sharon Civa makes her rounds. As one of Penn Medicine’s Information Technology Officers, Civa is responsible for partnering with Penn Radiation Oncology as their information services executive, to identify, plan, and lead the advancement of information systems across the department. But the business that brings her to the halls of the Abramson Cancer Center (ACC) chemotherapy infusion floor on this particular day is less about data and more about compassion.
In Civa’s right hand is a basket filled with handmade cards, each designed with a unique message and hand-drawn art. Once a month, Civa, who has been with Penn Medicine for 19 years, visits the ACC to meet with patients and distribute the cards. What’s perhaps even more impressive, is that Civa can usually explain with some personal touch why one particular card might be a better fit for a patient than another. For example, the New Jersey resident knows that the card with the truck on the front – not the one with the bright yellow sun – is perfect for Don, a retired union member from the Wissinoming section of Philadelphia.
Inspired by her own battle with cancer, Civa has made over 8,000 cards since she began her mission in March 2016.
Q. Take me back to the beginning. What was your own experience with cancer and what inspired you to start bringing cards to chemotherapy patients?
A. I was diagnosed with ovarian cancer in July of 2015, and I had surgery almost immediately. Two months later, I started five months of chemo. The time in between surgery and chemo was probably the worst weeks of my life because that's when the fear really set in. I just thought, “oh my God, I have cancer. What does this mean?” Am I going to survive? And what is the treatment? What's chemo going to be like?
That’s when the fear was greatest, during that time, and then again at the end of treatment. I felt the most fear at the end of treatment because at that point you've gotten used to your regimen and you know how to handle it, but then it just ends. It's like you took away my weapon, so now what am I supposed to use against this monster? I really had to dig deep to come up with the courage to move forward.
Q. How did you get through those days when you were getting your chemotherapy treatment?
A. I had this very fearful vision of chemotherapy, and one of the things that really helped was a nurse who took me through the treatment floor. I was really surprised by how quiet it was. It wasn’t that fearful vision I had in my head. I was very grateful for that nurse, because it meant I could move on from that fear and deal with what the side effects were going to be for me, and prepare for that. It’s not an easy journey, and it’s unique for everyone. But I was able to walk around during my treatment, and I felt like I was lucky. And that perspective helped me through the process.
Q. How, and when, did the cards come into play?
A. I received cards during my treatment. I received homemade, store-bought, and custom cards from friends, family, and strangers, and every one of them is precious to me. To this day, they're still displayed in the corner of my house. They’re a reminder of not only what I went through, which made me stronger, but also of the people who cared and people who knew what to do and what I needed. A simple card really means a lot. It means somebody is thinking about you, somebody thought enough to send it to you, so it's a really meaningful thing. That’s why I chose to do it myself.
Q. What’s the process for making the cards? How do you find inspiration?
A. You know, when I was going through my treatment, I collected all these images on my iPhone of positive pictures or sayings, and that helped me. One week, I thought that I needed to look up messages of hope. So, I would go through and find all these things that I liked about hope and I put them in a folder on my phone. And then another week I felt like I needed courage and I found 450 of these images and phrases, and I would just scroll through them. I would just lay in bed and read them over and over. That’s really what I'm trying to recreate in the cards. There might be somebody who needs hope the same way I did.
Q. How many cards do you make a month?
A. I'd say at least one hundred. Sometimes more if it's a good month. The distribution varies. If I have a long visit with one patient, I might not get to as many that day. But I do give a supply of the cards to the volunteer office so their staff can give some out when they visit inpatients.
Q. When you look back on the 8,000 cards you've distributed, are there any stories that stick with you, or that stand out more than others? Have you formed a relationship with anyone that started with delivering a card?
A. People love getting cards, and they love how it makes them feel. A lot of people will say, "Someday I want to do this” or “I want to volunteer," and I invite them to be a part of this when they're done with treatment. I think it's another way for people to have hope for the future and a way for them to give back. I've had people cry with joy when they receive a card from a stranger, and those two are connected.
Q. What is it that you want to communicate through the cards?
A. A lot of what I hear back is that, “you've given me hope,” which is exactly the reason I do it. To give somebody the hope I needed so desperately when I was going through my treatment. Back then there was no chemotherapy volunteer program. Today, the chemo volunteer program is two years old. I had the idea, and went to our patient and family services department. I partnered with the director there and we built a pilot program, and now there are five volunteers, all of whom have had treatment here, and I really hope to keep seeing that growth.
Q. What do you think it means to patients when they see you and other volunteers?
A. We're not there as a clinician. We're there as a peer who sat where they’re sitting. Some people want to talk about their experience. Some people don't, and I respect that.
I also try to be an ambassador for the complementary services that Penn Medicine offers, because I used them. Whether it’s the counseling, support groups, Reiki therapy, or massage therapy, I want people to know that these services exist.
Q. Is there anything special that you’ve taken away from this experience?
A. What I have is gratitude that I didn't have before. Gratitude for the simplest things. I've seen too many people who can't eat during their treatment, or after their treatment, or do other things like walk. I’ve seen these side effects take their toll at every stage of cancer. So, I would say gratitude for being where I am today, and gratitude that I can help others in a small way.
Q. I’m sure a lot of people who read this will ask themselves, “what can I do to make a difference?” What advice would you give to those people?
A. Everyone can do something. You know, if you have an idea or you want to give back, pursue that. Just find the person to talk to about how to make your idea into a reality. And know that everything is appreciated. The simplest things can be meaningful to somebody. It does not have to be a big, grand gesture. Just taking 15 minutes out of your day to make a card can be very meaningful to someone, and it's not something that takes a lot of equipment or a special skill set.
Interestingly enough, I never drew or created a thing in my life before I had chemo. If you had told me 10 years ago that I would be making cards, I would not have believed you. I didn't feel I had a creative bone in my body, but I actually don't think it matters so much to the other person what the card looks like. I think that matters to me. And that's my outlet. It’s what gives me joy and peace. To the receiver though -- I’ve had five-year-old kids who have made cards that have gone to patients, and they absolutely love them. This is especially true if they have kids, and grandkids. They love getting a card that was made by a child. It’s not really what it looks like. It’s the effort and thought that went into it.