Annie Slater MD

“Only the good die young.”—Billy Joel

 

*My friend, Kristen Spangler recently passed away after suffering from colon cancer, which was diagnosed merely 13 months ago. We are the same age, and I am grappling with my many feelings of loss and sadness about her death. I want to properly memorialize her life and share what she meant to me, as I know I am only one of many whose life was better because she was in it.

 

Hi, I’m Kristen,” she said, with a big warm smile and a slight Canadian lilt, as she held out her hand for me to shake it.

It was 2009, and I had recently moved from Pittsburgh to Seattle for a faculty position at Seattle Children’s Hospital in the Emergency Department. I thought I was prepared for everything, the relocation, the idea of being an attending, my new city. What I hadn’t anticipated was the “Seattle freeze,” a way of describing how hard it is to make friends in this town, especially as a transplant. Loneliness had started to creep into my life, and I needed a friend, and I needed someone to be nice to me.

When I met Kristen, I was taken aback by her warmth. I immediately thought, “she must think I am someone else.” No one was that nice, especially in Seattle. She was genuine and compassionate, and was also at ease with herself and putting those qualities on display.

We formed a close professional relationship, Kristen was an excellent nurse, the kind I was always very happy to be working alongside when I would come on shift. She floated through the ER now and again, always with the same smile, the same unadulterated niceness that made me wish I could be kinder, more like her. She laughed and joked, she cared deeply for her patients, and she always was a soothing presence.

Kristen was also someone who was a “toucher,” you know, those people who put their hand on your shoulder, or hug you when they see you. Although at first it surprised me, and I wasn’t sure how to respond, I learned to love her way of being so quick to show affection to her friends. We do hard and exhausting work at the hospital, and it is always nice to have someone like Kristen who will hug you even if she doesn’t know you need it.

We got to know each other through the years. I started a job as a Medical Director for a summer camp for children with medical diseases (Camp Korey) and Kristen was one of the first people I asked to come and volunteer. In this role, I learned that *truly* the best people on earth take their vacation to volunteer at a camp for sick children. Kristen was one of them.

Not only was she a volunteer, but she was a spokesperson, getting other nurses to volunteer, coming to fundraising events, and it seemed like she was always helping me in some capacity. She came into camp and brought all of her warmth and personality, expertise and hard work to the job. She eased the fears of her fellow nurses, always stepped up when extra hands were needed, and she developed a strong relationship with the campers she took care of. I never worried when Kristen was there. She was the ultimate professional, she was excellent at her job and ALWAYS went above and beyond. With a smile.

Our friendship meandered forward, she worked on the IV team, and would often be summoned to the ER to put a line in a child that was a difficult IV placement. If we happened to be in the ER at the same time, she always came to find me to say hi, give me a big hug, and ask me about how I was doing. Her presence was comforting, and I loved that I could always be honest, whether things in my life were good or not, and I felt she cared. Sometimes she would see my name on the tracking board, and she would call my phone just to check in. Sometimes if she had a few minutes to spare, she would come down to the ER to chat.

A few years ago while we were hanging out at camp she told me that she wasn’t feeling very well. I remember that she was seeing all these doctors, both traditional and naturopathic to help determine what was wrong. She thought maybe it was undiagnosed allergies, maybe irritable bowel disease. We talked about her lab tests and what the doctors were telling her.

We continued to see each other intermittently at the hospital, but with less regularity.

Then, a little over a year ago, she had a colonoscopy and was diagnosed with stage IV colon cancer. Colon cancer is ominous, as it has a poor 5 year survival rate, and it is uncommonly diagnosed in our age demographic. When she told me, I remember wishing I had advised her to see a GI specialist sooner. I was also scared for her, I wanted to turn back time, back to when we chatted about her mysterious illness. Most of all, I prayed and I pleaded with God that she get through this, that she would be the one to defy the odds.

Time flew by, she had surgeries and chemo, I was pregnant with my second baby, who was born prematurely. We saw each other much more infrequently, but stayed connected via texts. Kristen continued to be the ultimate optimist, with unshakable faith and determination. Her hope was palpable, and although she went through some very hard days, she did so with a grace I admired.

She had a colostomy bag that she called “Ophelia,” and she joked about the noise the gas made as it traversed out of her abdomen. She lost her hair and put on the most fierce wigs. She shaved her head and went on vacation with her boyfriend to Hawaii. She traveled to see specialists in other parts of the country, and she tried experimental treatments. She also catalogued her experience on a FaceBook group page. This group gained 500 members, cheering her on, wearing pink socks that say her name, showing up to her chemo appointments to keep her company.

About a month ago, a mutual friend and I brought her lunch, she shared that one of the oncologists told her she may not have much longer to live. She was undeterred, she recognized that it would be good to “plan” for the worst case scenario, but she remained positive.

She talked about how hard it was to be sick, that certain people in her life showed up more than others, that she held no ill-will to those that had a harder time with her diagnosis, but that she appreciated so much those that could be there. Her face was pale, and she seemed thin, but she was the same charismatic person. She had hope, but also peace. My friend and I decided she should have a meal train, and we encouraged our friends to donate to her Gofundme. Kristen talked about how much the money helped, how she wanted to try some experimental treatment in another country, but that it was expensive.

Almost 3 weeks later, I saw her at work. She was getting lunch. Her smile was just as big, her hug just as warm, but I remember being worried about her.

That weekend she was admitted to the hospital.

Six days after her admission, she passed away. Her body couldn’t handle her illness any more, and she contracted an infection that she could not fight.

I am devastated and I know that everyone who was touched by her is also overcome with grief.

I regret that I didn’t tell her all of these things while she was alive. I mistakenly thought she had more time, that we all would have more time with her.  I also don’t understand why my sweet soul sister had to lose her life so early to such a horrible disease. I miss her and I think of her often. I admire the person that she was, and to honor her, I want to highlight some of her values, and think about how I can apply them to my life.

1. Love fiercely–Kristen was kind, she was compassionate and she was so quick to be present for her friends. When I had my first child, she gave me sweetest small gift, things that she thought I would need, and I was touched that she took the time to get me something really specific. She was unafraid to be present, deeply loving and showing that love to others. Unlike most of us, she didn’t wait for reciprocation, she just gave it out like she had a never-ending supply.

2. Check your lens–We all choose which lens to look at our lives. Kristen was given a very scary diagnosis at a young age. Despite this, she was so full of hope and optimism. I remember seeing her after my 33 week old baby was born, and I was struggling with sleep, fear, and generalized exhaustion. She was also struggling, but she still looked at her life through a positive lens. She talked about eating healthy and her faith in God. She helped me to understand that we are lucky to be alive, hard times are a part of this life, but we don’t have to let them derail us.

3. Be vulnerable–Kristen could have hid, she could have struggled in silence with her cancer. But that wasn’t the person she was. She wanted to share, to talk about it with people, to have others support her on her journey. She shared her hard moments and her victories, and it made us all feel a little closer to her.

4. Talk to strangers–The reason we became friends is because she was quick to meet new people, eager to make her circle of friends larger. I learned that in order to make friends, you have to be one first, and often that happens when you welcome someone new.

Lastly, live your life to the fullest. You never know when something tragic might happen, a scary diagnosis or an unprepared for event.

For those of you that knew Kristen, please leave a comment or story. She was amazing. Rest In Peace dear friend.

“Death is nothing at all. It does not count. I have only slipped away into the next room. Nothing has happened. Everything remains exactly as it was. I am I, and you are you, and the old life that we lived so fondly together is untouched, unchanged. Whatever we were to each other, that we are still. Call me by the old familiar name. Speak of me in the easy way which you always used. Put no difference into your tone. Wear no forced air of solemnity or sorrow. Laugh as we always laughed at the little jokes that we enjoyed together. Play, smile, think of me, pray for me. Let my name be ever the household word that it always was. Let it be spoken without an effort, without the ghost of a shadow upon it. Life means all that it ever meant. It is the same as it ever was. There is absolute and unbroken continuity. What is this death but a negligible accident? Why should I be out of mind because I am out of sight? I am but waiting for you, for an interval, somewhere very near, just round the corner. All is well. Nothing is hurt; nothing is lost. One brief moment and all will be as it was before. How we shall laugh at the trouble of parting when we meet again!”
–Henry Scott Holland