by Jessica Howard

Katie Vacanti Mitchell, a seventh grader at Woodland Middle School in Brentwood, Tenn., loves to crochet, play soccer and softball and kid around with her two brothers. Joke-swapping, good-natured teasing and silly gaffes are just a part of life for the close-knit Mitchell family.

A bittersweet escapade during the Christmas holiday resulted in the three siblings emerging with bald heads. When 12-year-old Katie, who has acute lymphocytic leukemia (ALL), decided it was time to shave off her quickly thinning hair, she wasn't alone for long. When her brothers saw her, they said, "Us too." This act of support soon became joke fodder as the trio laughed about their "new matching hairstyles."

When a child gets sick, the whole family is affected. While Katie carries her illness with her 24 hours a day, her family lives with the ramifications. For the Mitchells, our mission of family-centered care has been vitally important to the treatment process.

"From the time of their diagnosis, we all work very hard to communicate effectively with the patients and families, to try to answer their questions as honestly and as completely as we can," says Mike Engel, M.D., Katie's oncologist. "We know unknowns are scary and that by addressing these as they arise we can alleviate anxiety and build trust. Ultimately we want families to have information that they can use. Outside the hospital, they are our eyes and ears, and are an essential part of our care team. We need them as much as they need us."

Katie's mom, Melissa, praises Engel and the Children's Hospital staff for their efforts to equally treat the disease and the person. Keeping parents abreast of their child's condition is vital, but helping the patient understand what is happening to their bodies is even more important. And doing this in an effective way makes all the difference, Melissa says.

"It's all in the delivery," Melissa says. "Engel gives us a thorough medical and scientific explanation of what is going on then he follows it up with an explanation that makes a picture so Katie understands. The science is science, but the way that Dr. Engel treats Katie…she's not just a patient. She's Katie. That makes it a lot easier."

Katie echoes her mother's praise.

"I think he's wonderful," says Katie of Engel's bedside manner. "That's really what makes Vanderbilt special, the doctors and the nurses. It's less scary. Dr. Engel gives me all the information that I need."

When Katie and other patients come to the cancer clinic, they are greeted by a gracious staff offering a variety of comfort measures meant to make the treatment process as pleasant as possible.

"The nurses are consistently upbeat and it always feels like we are going somewhere to see folks we know and like as opposed to a hospital visit - again, it is all in the presentation," Melissa says. "They clearly have a heart for the children."

Recliners and blankets are available in a large room shared with other patients, promoting a communal environment. Movies are played on several television monitors to help treatment time pass faster. Sedation is offered to patients for procedures whenever possible, and snacks are ready for those hungry after their treatments are complete for the day.

In addition to medical care, Engel says he tries to help his patients and their families learn something new each time they visit. Katie's 11-year-old brother, Zack, a budding scientist, has become increasingly fascinated with medicine since Katie's diagnosis.

"Zack has obviously been affected by Katie's situation, and this is probably a coping mechanism. Zack is much like his mom; I think they both find comfort in information," Engel says. "Knowledge empowers patients and families, and that empowerment will serve them well as we go through this process together."

In turn, the Mitchell family has insisted that Engel take part in one of their family rituals.

In our house we have a thing called 'High, Low With a Joke,'" says Melissa. "We have our kids tell us the high point of the day, the low point of the day and then they end with a joke. We began doing it with Dr. Engel, too, just to mess with him, but let me tell you -- he really prepares. He always has a joke ready."

For Engel, these more personal interactions are just part of the day's work.

"All of our patients are special, and watching them go through this process is inspirational. We often hear people say that it must be hard to take care of children who are sick and facing life-threatening illness -- quite the contrary. I am certain I get at least as much, if not more from my patients and colleagues than they get from me. I see everyday that people care for one another and are inherently good. We support each other. We strive. We endure. We preserve. There is no greater privilege than to be constantly reminded of that. We all try to honor that gift with our efforts."

--

Helping while healing
Katie had a very big day a few days before Thanksgiving. It was a day she shared with her family, Monroe Carell Jr., several hospital administrators and a misty-eyed Engel.

On that day, Katie handed the Children's Hospital namesake a check for $2,000 and two crocheted bookmarks. The check was for the Children's Hospital; the bookmarks were a handmade gift for Monroe, and his wife, Ann.

Ever since Katie was first admitted to the Children's Hospital due to a common complication of her leukemia, she began to think about what a hard time it must be for patients and their families who don't live close to Nashville. Katie felt lucky to live close nearby, but knew it must be very expensive and tiring for parents and patients who had to travel long distances.

Between chemotherapy, spinal taps, blood infusions and all the discomfort that follows a rigorous treatment plan for a life-threatening illness, Katie set up a fund through the Children's Hospital called Katie's Helping Hand. The fund helps cancer patients and their families being treated here pay for incidentals like long-distance calls, meals and gasoline.

"I was raised that in your worst moments, you help other people," Katie says, "because there's always going to be somebody else out there that has it worse than you."

A growing army of youth and others are fighting for her cause. Local kids are asking neighbors for contributions and a girl several states away is selling "Live Strong" bracelets to raise money - all in the name of Katie's fund.

Melissa's employer, LifeWay Christian Stores, has been a big supporter of Katie's fund, and the first large contribution of $2,000 came from a Minnesota businessman who does business with Katie's mom.

Katie's father, James, works at Central Parking, the company Carell presides over as CEO. Central Parking was one of the first contributors to the fund. Katie cites Carell as an inspiration for her efforts.

"I learned from Mr. Carell that ordinary people can do extraordinary things," Katie says.

Acts of goodwill aren't unusual for Katie. Ironically, before she was diagnosed with ALL, Katie had been growing her auburn hair out to donate to a child with cancer. When her treatments began, she had her hair cut short so she could proceed with the donation, dismissing every suggestion that she could have the hair made into a wig for herself.

Katie's Helping Hand has reeled in more than $13,500 so far. Her determination to beat leukemia and to help others along the way has been an inspiration to all of us. To learn more about Katie's Helping Hand, visit Katie's Helping Hand.  Follow that link to "Making a Contribution."

What is ALL?
Childhood acute lymphoblastic leukemia is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated. It is the most common type of cancer in children, and makes up approximately 50 percent of Children's Hospital cancer patients. Last year, 137 children were diagnosed with some form of cancer at Children's Hospital. Normally, the bone marrow harbors stem cells (immature cells) that develop into mature blood cells. In ALL, white blood cell precursors known as lymphoblasts fail to fully mature, and instead accumulate in the bone marrow.

In ALL, the lymphoblasts are not able to fight infection, and other types of infection fighting white blood cells are not produced in sufficient quantity. Also, as the bone marrow is increasingly filled with lymphoblasts, the production of red blood cells and platelets diminishes. As such, patients can develop life threatening infections, anemia and bleeding complications. Survival from ALL is approximately 75 percent to 80 percent in children. International cooperation has led to significant improvements in leukemia therapy over the last three decades.

The Children's Hospital and the Vanderbilt-Ingram Cancer Center are at the forefront of this effort.


Editor's note: As of late January, returned to school for the first time in months.