Addressing the Elephants in the Room: Healing Through Discussion

In early November, Michelle Landwehr (The Samfund’s COO) and I traveled to Chicago for the annual Critical Mass conference: a meeting of the minds, so to speak, in the Adolescent and Young Adult (AYA) cancer world. As always, it was great to reconnect with friends and colleagues with whom I e-mail throughout the year, and it was especially exciting to see so many new faces in the room.

This year, the planning committee challenged attendees to have some hard conversations. We chose “Elephants in the Room” as the theme for the meeting because there are some topics that are almost universal to AYAs and yet rarely get talked about, because we (all of us) are so uncomfortable bringing them up. Sexuality and cancer. The fear, and the reality, of death and dying. Fertility preservation. Dynamic speakers like Dr Anne Katz (CancerCare Manitoba), Dr Lori Wiener (NCI), Nanette Elster (Spence & Elster, PC), and Dr Gwendolyn Quinn (H. Lee Moffitt Cancer Center and Research Institute/USF) not only captivated everyone in the room, but also, more importantly, gave us all valuable information, resources, and ideas for how to support AYAs who are dealing with these issues.

Nick Yeager, a pediatric Hematologist-Oncologist at Nationwide Children’s Hospital, and I were tasked with presenting the last workshop of the meeting, “Tackling the Elephants Together.” The focus of our presentation was collaboration, and we talked about why we’re not doing it nearly as often or as well as we should. The “elephants” in this conversation? Perceived competition amongst organizations/institutions. Ego. Time constraints. Not enough money. What we’ve found, though, is that it’s easier to tackle an elephant when you’re not facing it alone. We are all fighting the same fight, and together we are stronger.

Our goal was to call out the elephants in the room by naming them, discussing them and sharing lessons learned from collaborations (both failed and successful) at our respective organizations, and get everyone talking. We asked participants to identify their individual strengths as well as the barriers to previous or current collaborations, and then set them loose at their tables to find the common threads and strategize together on how to overcome these barriers and work together more cohesively.

As a community, collaboration is not just a “nice” thing to do—it is something we have to do. We owe it to our AYAs to make sure we are doing everything we can to make things easier for them. We are collectively facing the most expensive, extensive public health crisis in our society today, and working in silos isn’t as effective as joining forces to enact systemic change in how we deal with it.

For those who weren’t at the conference, we encourage you to address the elephants in your rooms, too. This diminishes their power and puts us back in control of the conversations that need to happen. In the end, everybody wins (except the elephants).