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From Uncertain to Whole – Runs a River of Gold: Oncology Social Worker Practice and the Alchemy of Healing
By John B. Garrity, LMSW

Hanging at the transition hallway point between the patient waiting area and the clinical treatment area of the Mollie Wilmot Radiation Oncology Center at Saratoga Hospital in Saratoga Springs, New York, is a painting gifted by the artist Letitia Splain Wyatt, (nee Dayer) titled From Uncertain to Whole – Runs a River of Gold. The work is a diptych (twin panels) that conveys a sense of darkness and ominous, scanlike spots alongside symmetrical flowing movement shaded with bright hues. As staff, we walk past it countless times in the daily, constant, repetitive cycle of accompanying patients to consults, radiation therapy treatments, and case conferences. Movement between the two parts of the clinic occurs with such habitual frequency that one often hurriedly and often unconsciously passes by the painting. And yet pausing, for even a moment, invites awareness that the story told by the twin canvas powerfully symbolizes the alchemy of healing specific to the artist’s own cancer journey and hides in plain sight the innate possibility held deep within the human condition to overcome, renew, and inspire.

As Letitia has shared in her presentations and exhibit material, initially after the spot discovered at biopsy and the onset of her cancer diagnosis her own “uncertain future seemed tainted with darkness,” and she was anxious and fearful, “Working with the paint that night,” she wrote, “helped me to breathe. I called the painting, Tenuous Threads of Uncertainty.” Months later, after surgery and with the promise of a good prognosis, Letitia described “finally learning to exhale,” and another painting emerged in the spring. “Borne of hope and sighs of relief,” the “image was imbued with joy” and titled A River of Gold Within My Soul. Surprised when she eventually realized that both the painting inspired during darkness and the hopeful image three months later were painted with the same palette, she “came to understand that there had been a vibrant energy within me from the beginning, which had sustained me through this entire crucible. I finally understood that this river of gold is always within me.”

As a social worker walking alongside cancer patients, part of my privilege and practice is to be a listening witness to the patient’s journey. A truly gifted place allows one to experience the strength of character by which patients endure the physical and emotional toll frequently demanded by cancer with the often-affiliated loss of control, disrupted equilibrium, and pressing existential questions. Often, it’s a paradox-filled journey, where light is found because of darkness, and brokenness invites new wholeness.

Letitia’s transformative crisis-driven journey and meta-emergence profile the possibility of repurposing the mix of one’s own unique palette. Trying to discern that alchemy, by which patients are at times powerfully able to find their own inner River of Gold, invites the social worker to the art of vulnerability, presence, comfort with ambiguity, curiosity, active listening, and acceptance. It invites relationships and a holistic prism actively looking for innate strengths, perspectives, and beliefs that might become the mycelium for the roots of hope and resilience. This sort of nondirective patient accompaniment invites the mystical side of oncology social work practice where, at times, one is privileged to behold patient movement from initial seismic disruption filled with the fog of uncertainty toward new consciousness, spaciousness, and the claiming of a fresh sense of wholeness and self-identity.

Crucible in this oncology treatment context is a liminal conversion process through which the base self-metals of our suffering, anxiety, doubt, anger, grief, and range of difficult emotions are refined and alchemically transformed into new alloys of self-understanding and awareness. In this sense, the patient herself is the alchemist. She finds inner acceptance, she discovers sources of hope, she is touched by an inner fire, she finds the media that inspire renewal, she finds the light, she births resilience. Tenuous threads of gritty uncertainty at times so consuming and overwhelming somehow morph as the disease becomes the teacher. She leans into the crucible and in a new and transforming way reveals new patterns and possibilities as the energies of dissolution give way to new creation.

Of the many profound lessons learned in this role of accompanying witness is the steadfast conviction that the human condition, even under extreme breakpoints, is encoded with an innate alchemistic power ever capable of finding gratitude and meaning. It’s an awe-inducing superpower, a type of unquenchable strength—perhaps best understood as inner gold—able to overcome distress in all its mental, emotional, and physical variations and bind threads of uncertainty into hope. As the poet Scott Hastie wrote,“The light needs only our trust. And, of course, the darkness to work its eternal alchemy.”

— John B. Garrity, LMSW, an NASW member, is an oncology social worker at Saratoga Hospital in Saratoga Springs, New York, who has a passion for growing garlic and spending time outdoors in the Adirondacks and Green Mountains of nearby Vermont. He credits the amazing example of hospital nurses for teaching him that “work is love made visible.”