EHA Library - The official digital education library of European Hematology Association (EHA)

Three years ago, a unit for autologous bone marrow transplant for hematological patients has been established in Shaare Zedek medical center. The patients meet with the doctors for the treatment plan usually following the diagnosis. From the point of view of a part of the patients, the process appears simple, short term, and promises cure. In reality, the process is long term, including aggressive chemotherapy prior to the transplant. The treatment is highly aggressive and toxic with many physical and mental side effects for the patient and his/her family. The transplant process requires hospital admission for about a month in an isolation room. No one is allowed in the room except for close relatives and the medical staff. The social worker, part of the caring staff, accompanies patients and families from the initial diagnosis through this taxing and stressful process. Most patients are young, average 45 years, in the middle of their careers, from a broad spectrum of occupations, education as well as social status, representing Israeli society.

The following tools had been utilized:

This work is based on therapeutic conversations that took place inside the isolation room with about 30 patients, mostly men, average age was 50, during the past three years. With the understanding that a patient goes from the public sphere to a private one -the isolation room- my entrance into the room was based on the ability and willingness of the patients to go into a treatment dialogue at that point and time. From the narratives of the patients, a few themes were extracted that were repeatedly discussed by most patients.

As cited by S.A, a 49 year old man 'I'm afraid to give in and die, help me to stay alive. And if I die, I want to know that I have left no unfinished business.'

From the therapy sessions it appears that the central issues that bother the patients belong to the private space and the coping with it. The process of treatment helps patients to go from the private sphere back to the public one.

It seems essential for the patients in the isolation room, undergoing autologous bone marrow transplant, to have therapy sessions with a qualified social worker as part of the holistic care. 'Having a room of his own' in the process enables an opportunity to examine the inner self esteem and strengths of the patients thereby patients learn to contribute to themselves from themselves.