Catalyst
Efigenia Viola Knows What Her Cancer Patients Are Going Through
Efigenia Viola remembers the moment she decided to become a nurse. As an 8-year-old girl in the Philippines province of Bulacan, she watched her cousin graduate from nursing school.
"I was in awe. I saw all the new nurses wearing white uniforms, white stockings, white shoes, and those caps," she says. "They don't wear caps anymore, but when I first saw them, I thought each was a crown. Beautiful enough for a queen."
"I'm so grateful because of what happened on my first day."
These women inspired Efigenia because they helped to heal the sick. She proudly joined their ranks in 1974, serving the poor on medical missions in her country before she moved to the United States. Efigenia spent 29 years as a critical care nurse at the Henry Ford Hospital in Detroit; then came a chance to join Cedars-Sinai.
"Some of my best friends lived in California, and one helped me get my job at this hospital in 2007. I'm so grateful for that because of what happened on my first day."
During a routine physical for all new employees at Cedars-Sinai, an X-ray revealed a nodule in Efigenia's lung.
Waiting for answers
Efigenia's new nursing job was on a recovery floor helping post-operative patients in the first hours after surgery. At this point, the possibility of Efigenia's own operation still seemed distant. She had a primary care physician near her home in Carson who recommended waiting several months for a follow-up X-ray. It revealed the same nodule with no increase in size.
She took the advice of a friend and saw a thoracic surgeon at Cedars-Sinai who confirmed that the spot on her lung was cancer. The tumor was removed using a treatment pioneered at Cedars-Sinai: video-assisted thoracoscopic surgery, or VATS. VATS allows a tumor or affected portion of the lung to be removed through small incisions, rather than more invasive surgery.
"I was lucky," says Efigenia. "The cancer hadn't yet spread. I didn't need chemotherapy or any treatment other than surgery."
Efigenia's luck has held up. Now 64, she's been cancer-free for 7 years.
"I tell my patients, 'I've been in your shoes. I was a patient myself. I had surgery like you had, so I know how it feels.'"
A special touch with her patients
Today Efigenia especially loves taking care of patients who underwent the same VATS procedure that preserved her health.
"I have the special touch," she explains. "I tell those patients, 'I've been in your shoes. I was a patient myself. I had surgery like you had, so I know how it feels.' And I promise them, 'You and I will develop a relationship even though it's a short period of time here in recovery.'"
Efigenia talks to these patients about pain and the chest tubes that are present following lung surgeries. She speaks from personal experience about the short walks they should take once it's safe for them to get out of bed.
"I'm here to find out what they need and to help heal them. Their families need me too. They also have anxiety, sometimes more than the patient."
"You tell them what to anticipate about their recovery. Some try to be brave and ignore their pain or other concerns, but I'm here to find out what they need and to help heal them. Their families need me too. They also have anxiety, sometimes more than the patient."
Efigenia goes out of her way to reassure those family members—all of whom have to wait at least an hour to see their loved ones after surgery. "I give them updates or page the physicians to answer questions. I'll take someone aside and say, 'I understand you are worried, but we can work together to take care of your husband.' Or maybe it's their wife or child, or sibling. We join forces to make the patient they love comfortable."
Showing gratitude by passing on the "crown"
The patients and families who Efigenia serves are often grateful for her care, but Efigenia herself is thankful for many things.
"I am a grateful cancer survivor. I can say that because if you don't have a recurrence for 5 years, you are considered a survivor. I'm also grateful that I found a job at Cedars-Sinai. Sometimes if you have a lung tumor, there is no shortness of breath or other symptoms until it's in the last stage. But they caught mine early, and at a hospital known all over the world. We have patients who come here from out of the country for their surgeries. They've heard they can trust us, and I'm living proof that what they've heard is true."
Efigenia donates money every year to cancer research and also passes on the nursing crown, so to speak, by mentoring younger nurses.
"I am a grateful cancer survivor. I can say that because if you don't have a recurrence for 5 years, you are considered a survivor."
"I teach new grads or trainees in the recovery room—a couple of nurses maybe once or twice a month. It's part of my job but also another way of saying 'thank you' for my good fortune. I hope these younger nurses never become patients, and yet that's a way to realize what the people we help are going through.
Efigenia teaches this next generation of nurses how to better communicate and empathize with patients and their families.
"What many patients fear is the unknown," Efigenia explains to new staff. "It's the same for their loved ones before or after the procedure. That's normal, being scared of the unknown. So we describe what to expect as best we can. We've been around that corner with other patients, and that's how we know what to say. We try to tell it like it is."
Efigenia is a grateful patient, employee, and supporter of the Campaign for Cedars-Sinai. Learn more about the Campaign.
Are you a grateful patient, family member, volunteer, or loyal supporter? We want to hear from you. Your story can inspire others who may be facing similar challenges—and most importantly, provide hope. Share your story of gratitude or see how others are sharing #CedarsGratitude.
