The night before the first day of school.

DOI: 10.1200/JCO.2014.60.5790 So many years out of school and that feeling returns again. Part nausea, part excitement, part dread, part wonder that another summer is over and another school year begins. It is the night before the first day of school. As a student, the end of summer break somehow became easier to handle with each passing year. Maybe it was maturity or experience or confidence that the school year would be OK. Or maybe I just learned to accept the inevitable. Now, as a parent with that anxiety and opportunity once removed, each school start brings unique perspectives from each of my children. And like so many things, through my children, it is easy to feel school-aged again. I am hoping that the teachers will be nice, wondering if any of my children’s friends will be in home room, and curious about who will have lunch at the same time. And I am more worried than ever that the teachers will give too much homework. As a pediatrician, my patients provide a unique perspective on school. Working in the emergency room many years ago, I was helping a very sick child— getting oxygen for him, putting in an intravenous tube, and handing off my other patients so I could focus on this one sick child. Amid all of the rushing to help him, he turned to me and asked me to get his school bag. He said he needed to study and do his homework. I told him that it would be OK to take the night off, but this 11-year-old boy from the inner city removed his oxygen mask to tell me, “Non scooli sed vitae diskemuse” (Fig 1). I figured he was babbling from too little oxygen going to his brain. But when I looked confused, he said, “You’re a doctor. Don’t you know Latin? It means ‘Not for school but for life we learn.’” If only I had learned that when I was his age. . . It is once again the night before the first day of the new school year. My own children and other kids across the country are clinging to the last hours of summer break. But as a pediatric oncologist, I know one 15-year-old girl is hoping for morning to arrive so she can see her friends, and be a kid, and maybe learn something, not for school, but for life. Christy has a recurrent malignant brain tumor that no one knows how to cure. For patients with the worst types of tumors, we try to set realistic goals. What are some of the things you want to do while you can? Amazingly, most of our patients, even children and teenagers, can answer this question. After her high-grade glioma recurred the first time, Christy danced at the prom party we throw at the hospital for all of our patients. And I mean, she danced. After her tumor recurred a second time, we thought it would be a small blessing if she could be strong enough to make it to see her favorite boy-band in concert. And she did, first class, limo and all, thanks to some great philanthropy. And then her tumor progressed and before she was too weak to get around, we asked what else she was hoping to do. The typical answers are “another trip” or “shopping spree” or “I want to be there for my cousin’s wedding.” But Christy’s great wish was to make it to the first day of school, the first day of 10th grade. So tonight, my boys are tucked in and hopefully looking forward with more excitement than dread to another year of school. And they and I know they will be OK. This year the transition will be easier than last year, and next year will be easier still. But I have never been more anxious before the first day of school than I am right now. I am Fig 1. Photo of Latin quote from 11-year old patient. JOURNAL OF CLINICAL ONCOLOGY A R T O F O N C O L O G Y VOLUME 33 NUMBER 13 MAY 1 2015