Caroline, 6

Making Lemonade Out of Lemons

Caroline, 6

“It’s not my hair that makes my beauty,” said Caroline Morris. “It’s my heart.”

Those are big words for a 6-year-old, but after spending time with the spunky kindergartener, I wasn’t surprised by her comment. Diagnosed last summer with acute lymphoblastic leukemia, the most common type of childhood cancer, Caroline has remained upbeat throughout her weekly treatments, trips to Richmond from her Stafford County home, and loss of her hair, giving new meaning to the “Make Today Awesome” words on her pink t-shirt.

“Every day I make people laugh,” Caroline said. “My mom was a little sad I got this cancer. When my sister felt sad, I cheered her up with laughs.”

For Caroline’s mom, Carla, “sad” is an understatement. Last June, Caroline had a low-grade fever, stomachache and low energy. By the end of the week, she was still complaining about her stomach and had lost 10 pounds. Carla and her husband, Kyle, took Caroline to a local emergency room where physicians immediately referred her to Children’s Hospital of Richmond at VCU (CHoR).

“As soon as we came [to Richmond], the doctors started using that word – leukemia,” Carla remembered. “I was in a blur and so panicked.”

Caroline was admitted to CHoR and underwent multiple tests to determine the cause of her illness. Although her blood tests were clear, a bone marrow biopsy revealed leukemia, and Caroline began months of intensive weekly chemotherapy treatments. She also had a blood transfusion, which, in true Caroline fashion, she turned into a party with made-up songs and a jump rope for her stuffed animals created with her IV line.

“She handled everything so well,” said Carla of Caroline’s nine days at CHoR and subsequent outpatient treatment. “Her attitude through the whole experience set the tone for our family.”

Finding the Right Fit

Even with her positive attitude, Caroline suffered side effects from inpatient chemotherapy including high blood pressure, difficulty walking and nausea. Because leukemia can be in spinal and brain fluid, she had spinal taps almost monthly, and at one point, took a 28-day course of steroids, which made her body puff up and left her famished. When India Y. Sisler, MD, medical director of the ASK Pediatric Hematology and Oncology Clinic, met Caroline during her weekly outpatient treatments, it wasn’t unusual for Caroline to cry or become frustrated if she had to work with anyone other than her favorite nurse.

“As we got to know her and involved her family to tap into her personality, visits became easier,” said Dr. Sisler who worked with Child Life therapists and clinic nurses “to develop procedures to make the experience as easy as possible.”

Those procedures include a “button dance” that Caroline does before her port, a small device inserted under her skin to deliver chemotherapy, is accessed and “making up elaborate and hilarious stories,” said Dr. Sisler, recalling a time when Caroline decided they should be like Robin Hood and take candy from the clinic’s back room to share with siblings of patients who didn’t have candy.

“Caroline has a personality much bigger than her six years,” said Dr. Sisler. “Everybody knows who she is, and not a single person isn’t smiling [by the time] she leaves.”

Cooking with Caroline

“I want to be a chef when I grow up,” said Caroline, who records “Caroline’s Kitchen” video cooking segments that Carla shares with family and friends as part of Caroline’s treatment updates.

She loves to make donuts, omelets and biscuits and is excited about making lemonade cupcakes to sell at a lemonade stand this summer during Anthem’s LemonAid event to benefit the infusion center in the ASK Hematology and Oncology Clinic. Caroline is this year’s event spokesperson and showcased her cooking skills on a live morning television program in February to promote cancer awareness.

“I love being on live TV,” said Caroline, who had no problem in the spotlight. “Caroline’s Kitchen inspires people to cook.”

Caroline also inspires her fellow patients by decorating the clinic for holidays and talking to them when they are scared. “I tell them to take a deep breath, close their eyes and count to a certain number,” said Caroline who counts to “five My Little Ponies,” a reference to one of her toys.

The Road Ahead

On January 26, Caroline completed her last weekly chemotherapy treatment and in February began an 18-month maintenance phase, which includes taking chemotherapy and steroid pills at home and making monthly visits to CHoR.

“When you come here, it’s like a family,” said Carla who, ironically, was sorry to end the weekly visits. “The moms support one another, the doctors can be silly with kids, and I never have to worry because Caroline’s in great hands.”

This winter also marked another milestone for Caroline – starting kindergarten. She couldn’t wait to start school – until she came home from her first day and matter-of-factly told Carla, “school gets in the way of my day.”

Not surprising to hear from the little girl who told me earlier, “I’m busy all the time.”

And busy she is.

“I’m going to ask you guys some questions now,” Caroline said as she pulled out her paper and crayons, signaling the end of my questions. “This is going to be a long meeting but fun.”

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