Cancer Care Connections
Cancer Care Connections
The Compassion of Nursing and Storytelling
Join us as we welcome Gina Bright, an infusion nurse and remarkable author. She offers a heartfelt narrative about her early encounters with AIDS patients amid the fear and stigma of the 1980s and shines a light on the compassion and resilience required in nursing. Her unique blend of caregiving and literary talent offers an enlightening perspective on the vital role nurses play in the healthcare system. Her novel, The Charon Club, draws from personal experiences to depict the multifaceted roles of nurses, who navigate not only medical challenges but also the profound personal journeys of their patients.
Gina M. Bright, RN, PhD, OCN, has worked as a registered nurse in the fields of oncology and AIDS for several decades. Gina’s first novel, The Charon Club, was released in 2023 and was an NIEA Finalist for General Fiction in 2024. She wrote a non-fiction book, Plague-Making and the AIDS Epidemic: A Story of Discrimination (Palgrave Macmillan, 2012) years after working on an AIDS unit in NYC. Several of her short stories have been published and one of them has been included in the recently released anthology, Across the Moors and Tides: A Historical Fiction Anthology of the United Kingdom and its Territories (2024). Gina has a doctorate in medieval English literature works as an oncology nurse at Virginia Oncology Associates.
Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.
Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.
00:05
Welcome to Cancer Care Connections. On this episode, Cheryl spoke with Gina Bright, an infusion nurse with Virginia Oncology Associates. Gina is also an author who has written both fiction and nonfiction books exploring discrimination against certain groups in the healthcare industry. Today she's going to discuss her perspective of patient care through her personal experiences working in oncology and on an AIDS unit in New York City, as it relates to her novel "The Charon Club". By sharing her stories, Gina not only honors the memory of those affected by past medical crises but also educates and inspires future generations to continue the legacy of empathy and dedication in nursing.
Cheryl
00:55
Our guest today is Gina Bright, who has been a registered nurse for 38 years in the fields of oncology and AIDS, and has worked at Virginia Oncology Associates since 2010. She has a doctorate in medieval studies from Lehigh University. She wrote a nonfiction book, "Plague Making and the AIDS Epidemic: A Story of Discrimination" that explores the stigmatization marginal groups of people have endured across centuries during outbreaks of infectious diseases. Gina's recent novel, "The Charon Club", is the first of its kind solely devoted to the work of AIDS nurses, whose actual memories and experiences unfold through characters who help to find the cause of a new infectious disease in a fictitious present-day USA. Gina, thanks so much for talking with us today.
Gina
Thank you for having me.
Cheryl
Yeah, it's great to have you on the show and I'm just curious how did you get your start in both nursing and writing? And I'm going to assume here that they were at different times. That you got your start in both they were at different times.
Gina
01:55
I went to nursing school at the age of 18. I went to one of the old Florence Nightingale schools of nursing, a hospital diploma program. Most of them have closed. It was a three-year program and that was in 1983 when I started nursing school. About halfway through nursing school, I went to nursing school in Pennsylvania, we started seeing AIDS patients because AIDS was starting to trickle out of the major cities. And I actually took care of my first AIDS patient on an oncology unit in 1985.
02:29
However, I never thought I was going to be an AIDS nurse. As a matter of fact, I knew I wanted to live in New York City. And I didn't grow up there. Where I am from in Pennsylvania is about an hour and a half from New York, and I have relatives in New York too. But I wanted to work in New York and I interviewed at several hospitals. I chose Mount Sinai and I chose oncology. So I was an oncology nurse from the beginning. That was in 1986. And about eight months into that experience I was also doing overtime because we didn't get paid that much back then. New York was expensive. I was doing overtime on a VIP unit, that's what they called them then, where wealthier patients went and got really great hotel-class care.
03:12
I met and took care of one of my first AIDS patients named Larry, who was the second patient in the country diagnosed with Kaposi sarcoma. That was before we even knew what AIDS was, what HIV and AIDS was, and I convinced Larry to come to my unit on the oncology floor to get the care that he needed as he was getting sicker. So that kind of then led into...they were opening an AIDS unit at Mount Sinai and one of the educators had asked me to come and work there because, quite frankly, back in even 1986, nurses really did not want to take care of AIDS patients. They didn't want to even enter their rooms. So not only did I not have a problem, I felt very committed to doing that because it was just appalling how they were treated and I thought that I could give them the care they needed. So I transferred to the newly opened AIDS unit in November of 1987. And I remained on that unit until 1994. So that's a long time to take care of a population like that because we had no medications. We still don't have a cure, but we certainly did not have any effective medications during that time. So we pretty much, you know, we dealt with death every night, usually a few deaths every night, for those years.
04:29
And then I was studying English literature. I was always drawn to English literature also, so I was studying English literature at Pace University, doing that part-time, as I did my nursing full-time. One night, and that's in the beginning of my first book, "Plague Making and the AIDS Epidemic," I had a patient who was a Broadway dancer, Cisco was his name, and it was a really crazy night. We had four patients in rooms. Usually, that's where we were delegated to be in the hospital and he asked me when I was going to write their story because he knew I was studying English. And I said, "I will one day." That came much later, but that always stuck with me.
Cheryl
05:10
There's so much passion in your work. You can tell by the stories that you share and clearly by what you have lived through helping these patients. It needed to come out. Is that something that you would say because your patients were asking when will you tell our stories? But it felt like it needed to come out, that people needed to know.
Gina
05:29
I think that's right. I left the AIDS unit in 1994, which was right on the cusp of highly active antiretroviral therapy coming out in 95, which those are the drug cocktails now that pretty much keep everyone alive with HIV and AIDS. And it's interesting, I kind of feel like graduate school was almost an escape in some ways from all of the tragedy that I had been dealing with for all those years.
05:54
But I was drawn to medieval literature. I think a lot of it had to do with the horrible diseases that happened in the Middle Ages. The bubonic plague killed two-thirds of the European population. But I didn't talk much about AIDS during graduate school and I guess when I really started dealing with my nursing past, I was teaching, also at Lehigh. I taught freshmen and we were allowed to, you know, create our own courses and I created a course called "AIDS: Is it the Plague of the 20th Century"? And that was really what became the seeds of the first book. But the students, it was very interesting, I didn't want them to think this was an AIDS class, but they saw, on the bookshelves, all the books that I had chosen, with the topic. It was interesting, that was in 1998. So there was still an enormous amount of fear in that generation regarding transmission of HIV. So that's when I actually started to deal with it.
06:47
Now, during that time I was also writing my dissertation, which has nothing to do with HIV or AIDS. But when I got closer to getting my PhD, my choice was, that I was going to either have to be a full-time professor or continue as a nurse. And I never stopped nursing during graduate school, so I did part-time nursing during graduate school. I could not even imagine my life without being a nurse. So, much to the dismay of many of my professors, I decided to continue in nursing full-time. And then I decided it was a great idea to continue writing, but in a different way, outside of the academic world.
Cheryl
07:27
Here's what I'll say, first, thank you for your service. Just having read "The Charon Club"...and you talk about the dedication and the desire to help, that the nurses in your book have. I'm imagining that is something that you have taken from your life, even though it's a fiction book, you've taken that the heart. The heart is what I feel like you've taken into that, and so, as we focus a little bit on that, can you talk a little bit about nursing in general? You mentioned that you couldn't give it up. You couldn't imagine a career without nursing in it. You talk a little bit about nursing as a career and what you hope people get out of it from a book like the one you just wrote.
Gina
08:14
I hope that if non-nurses read my book, I hope it inspires them to be a nurse. You know, the reason I wrote this novel is that nobody else wrote a novel that captured what nurses do. And people who try to and even with successful novels, really don't get what we do. You know, we are the ones there at the bedside or the chair side here at Virginia Oncology Associates, with patients depending on us and putting their faith in us to guide them through their treatments. And even more than their treatments, we get to know them as people, as whatever they are professionally, as whatever they are in terms of their family and their positions in their families, and we get to know them like they're our own families. And we also are the ones who really start talking to patients about where they are on their cancer journey; if that's going to be a cure or just living with the cancer or, unfortunately, dying from the cancer. To me, that is just incredibly fulfilling, and also I just feel compelled to be there for them.
09:25
I tell you, we have been taking in younger and younger nurses who don't have oncology experience and I've been working with a lot of them. They're blown away by what we do, and you see them day by day starting to appreciate how difficult oncology is as a field. A lot of our patients are very, very ill. They're in pain, they're suffering from the treatments in terms of nausea, diarrhea, and no appetite. I have a few patients right now who have lost 50 pounds in the last two months, and that's devastating. You know they can see what it takes to stay connected and care and guide these patients to a better place than where they are right now.
Cheryl
10:15
As I was reading your book, I was thinking that not only for future nurses would this be a really beneficial book to learn from, but it would also be something that maybe patients' families could get something out of. Just to understand what is happening. Of course, it is a book of fiction and I want to talk about the book itself in a moment, but just to understand the feelings and the dedication.
Gina
10:42
Yeah, one of my patients right now said, "Oh, Gina, I need to talk to you for a minute." I said, "Well, of course. Just give me a minute, I'll finish what I'm doing and I'll come over and talk with you." I thought she was going to tell me something terrible that she was experiencing at home. She pulled both of my books out of her bag, I never even told her that I wrote these books, and she said, "I just wanted to tell you. I know what you nurses do, but I had no idea what you really do behind what we see and what you feel." And she said she was very tearful through both of the books and thanked me for writing them. And she said she shared especially the novel with her own family.
Cheryl
11:22
Gina, I would love to talk more about your novel, "The Charon Club", and why you decided to write this after your nonfiction work, and then I'd love to hear more about the title, and why you titled it the way you did.
Gina
11:35
I never thought in a million years that I was going to write another book about AIDS. My voice gets a little shaky. It was an incredibly painful time. It really is the equivalent, probably, of going through war. I've talked to patients of mine who are Vietnam vets and they have always said when they heard how long I worked on an AIDS unit that they know exactly how I feel because that's what they're experiencing too. So my first book, the nonfiction book I felt compelled to write that because I didn't think there was anything written, even though it's very academic, from a nurse's perspective; somebody who was there on the front line. It took me six years to write that book and, of course, I was working full-time as a nurse that whole time in oncology. I was very fortunate to have it published. I never thought that I was going to do this again with this subject. In 2018, this is all pre-COVID,
12:24
I read this great novel by Rebecca Makkai, called "The Great Believers", and it is a great novel. She focuses on the arts community, primarily the gay arts community in Chicago, and their experience with AIDS in the 80s and the effects of this illness on the community and their families. She had a moment where the nurse was coming into one of the patient's rooms and she had the nurse, asking what they wanted for dinner or something, as if we were dietary nurses. To me, she did not capture what we do and at that moment I decided...I said to my sister, we were actually on vacation, and I said, "I finished the novel." I said, "This is a great novel. I'm glad she wrote it, and I can't believe I'm going to say this, but I think I need to write another book about AIDS. And I think this time it's just going to focus completely on what we do as nurses." So that's when the idea emerged.
13:23
I did not know at first how I was going to proceed. I thought I needed to make it fictional so that I'm not chained to all of the facts that happened to me and other nurses. But I wanted to make the fiction seem like it was very, very real, so I came up with this. This is all pre-COVID. I thought, how am I going to get these nurses back together again? So that's how I wanted to do it. I wanted them to be AIDS nurses. Now, how am I going to get them all together again? And I thought, well, let's get another virus out there, that'll get them together again. Again. this was in 2019, so we're still pre-COVID.
13:58
I didn't want it to be a real virus either. I wanted it to be a virus that has not infected humans, so I started looking in zoological magazines and stuff. So there's this virus out there called porcine circovirus. It infects pigs. In pigs, it causes a very similar syndrome to HIV and AIDS. It causes immunosuppression. It causes problems with the kidneys. You can get purple lesions on your skin. So I thought, oh, this is the virus. Now, how am I going to get this virus to jump from pigs to humans? I won't say too much more, but that's how the novel begins. It begins with pigs. I created nine characters who are kind of loosely based on all of the nurses who I've worked with, and I wanted them both from the East Coast and the West Coast, because the West Coast, San Francisco and LA in particular, dealt with a heck of a lot of AIDS,
14:48
and I knew that there was an AIDS unit. The first AIDS unit was in San Francisco at San Francisco General Hospital called 5B. So, I contacted the San Francisco Public Library and asked if I could come look at their archives because their nurses kept this big ledger of all of the patients who died and there's an AIDS section in the special collections room. The librarian then hooked me up with Allison Moed, who is one of the first AIDS nurses on Ward 5B at San Francisco General Hospital. We got to meet and we had dinner. I got to see what they experienced on the West Coast.
15:28
It pretty much was the same thing we did. Their patient population was probably a little different. It was primarily actors and I would say 90% of their population was homosexual, whereas our population in New York, the AIDS population, started changing over from homosexual to IV, drug abuser, heterosexual, and more women. We had a lot more women. There were hardly any women on that unit in San Francisco.
15:53
So, I used all of that to create the characters. I have five characters from the East Coast, all nurses, and five characters from the West Coast. I also wanted to make the nurses themselves very diverse, because that's what we were. I mean, people were not typically attracted to care for AIDS patients if they didn't have pretty open minds about what we were dealing with as human beings. I have five cisgender characters, two gay male characters, two lesbian characters and I have a transgender character who is a real scream, named Cal. Cal was the character who connected the East Coast nurses to the West Coast nurses because he moved from New York to California.
16:38
Anyway, I have them all come together again and the event that brings them together is the display of the AIDS quilt on the National Mall. I have it being shown for the last time because of my imagining of the political world that we were living in in the United States in 2021.
16:56
They come together again and that's when they are invited secretly to consider taking care of these new patients with this PCV at the National Health Center, as I call it, instead of the NIH. The nurses who have been taking care of them, to begin with, and it's only like a few patients when that virus emerges, have a hard time taking care of those patients because I have those patients be white supremacists. Listen, our job as nurses is to be able to take care of anyone, no matter what your beliefs are, even if they're ugly and even if they're wonderful. I deal a lot with how nurses do that throughout the novel. So, the AIDS nurses come together again at the Holocaust Museum, and the Holocaust is a big theme in the novel, and I have them go on duty again and take care of these patients with this new virus.
Cheryl
17:51
It's an incredible amount of research that you did to put this novel together, and I keep thinking you were working full-time preparing all of this. How did you do all of that? With the mental stress, your day-to-day job, and then you're also writing about it, even though it is a fiction world.
Gina
18:09
Yeah, and then of course COVID came and I was near the end, like the final parts of the novel. So I was like, oh my gosh, I can't even believe that this has happened. Usually, I write before work and then I have off on Fridays because I do four 10-hour shifts, so I write all day Friday and then a little bit on Saturday. But yes, this was a different kind of stress in terms of, emotionally, what I was going through as I was writing it. I had to shut that off to go to work.
18:37
I remember one day in particular when I was filling in at the Harbor View office because I was in research at the time when I was writing this novel. But when COVID hit I felt compelled to go back into direct patient care as an infusion nurse. I started doing that when COVID kept getting worse and worse and some of our studies were being put on hold. We weren't recruiting so I had time to do that. But I remember one day in particular when I had finished writing something about one of my patients in the AIDS novel who died from Kaposi sarcoma. I remember going to work and dealing with a very young gentleman with non-Hodgkin's lymphoma, and as I was talking to him, I had to really turn off what I had just been writing because it was painful and I had to be there for the patient, which I was.
Cheryl
19:26
So much emotion. And I know that people who read the book will get an idea of the compassion and the stress, the mental stress, that it can take on the people who are there and dedicated. I want to talk a little bit about the title of the book. Where did that come from and can you explain what it means?
Gina
19:45
Yeah, that was the other thing, what was I going to name this book? Unfortunately, as the original AIDS nurses, what we did primarily was help people die. We were their emotional support system because a lot of people back then did not have families who wanted anything to do with them. We made sure that they were not suffering, and you know whatever that was, whether that meant physical suffering, actual pains, giving them pain medication, or the emotional and psychological suffering that so many of them endured. We were there for that too. So, looking through, with my background in English and medieval studies, I thought we really felt like we were carrying them somewhere, you know. And so Charon is a figure in Greek mythology who transports people from the world of the living to the world of the dead, and so he's a ferryman. And I think that's what we did as AIDS nurses pre-1995.
Cheryl
20:45
I would love to talk more about the work you're doing today in oncology at Virginia Oncology Associates and how this work that you've written can maybe give a window into how other nurses can view their careers or how patients and patients' families can see what is happening in the medical world. Now, of course, this is a piece of fiction, this particular writing is, but I think it gives a window into what's happening.
Gina
21:16
Yeah, I was just talking to one of my patients yesterday about this. She has non-Hodgkin's lymphoma. She's a stage two to three bordering, so she's curable, which is great. She asked me something about the Rituxan that she gets which is part of the r chop therapy, the regimen, Rituxan. And I said to her, "It's actually fortunate that you have non-Hodgkin's lymphoma right now." And she said, "What do you mean?" And I said, "Well, Rituxan was not around back in 1994," for example.
21:51
Jackie Onassis Kennedy died from non-Hodgkin's lymphoma because she did not have Rituxan." We didn't have Rituxan. And she said, "Wow, I never thought of it like that." She said, "So I'm like lucky." I said, "You know, let's not get that far. You're not lucky to have cancer, but you're lucky that we can treat you now and cure you." And that's something I like to talk to my patients about because it gives them a great deal of hope and encouragement. I wouldn't say that if we didn't think that was the direction that they were headed in.
Cheryl
22:15
It's a different perspective that you are offering. So what can you say for people who may have a loved one, who has gotten some sort of diagnosis, an unpleasant diagnosis; maybe it's the patient, maybe it's a patient's family member. Someone like you who has been there to serve so many families in oncology, in medical crisis, what kind of message can you give to a patient, to a family member, or to a friend?
Gina
22:47
We have so much to offer now that we did not have before. Immunotherapy has absolutely revolutionized the field of oncology. People with melanoma used to die, and that's not to say that people don't die now, but very, very few do. They are now either cured or living in remission thanks to immunotherapy. Breast cancer patients, back in the 1980s, when I was in oncology and nursing school and then my first oncology position at Mount Sinai, there were not many lines of therapy. We have, I don't want to say endless lines of therapy, but it is amazing. I have metastatic breast cancer patients who can live 15 to 20 years and even die from something else. So it's a very hopeful field, where I don't really think it was decades ago. I think all the oncologists would agree with me and I think all of my fellow oncology nurses who have been in it that long would agree with me also. The main thing is hope, and we really like to stress that.
Cheryl
23:47
Yeah, there's one thing I wanna bring up from the book as well and it was kind of at the end, but the theme of mentorship. I'm wondering if maybe you would consider addressing that a little bit. Of course, I'm not talking about what happened in the book itself, but it seemed like there was a theme of mentorship where younger nurses get the experience of nurses who have been in the trenches for a very long time. I really like that.
Gina
24:12
Yeah, and I think it is so important for all of us older nurses now to be, first and foremost, kind to younger nurses because sometimes I think that can get lost. Not here at VOA, but I certainly have seen that in the hospital setting with nurses who are burnt out from doing this for so long. It's also an important thing to constantly, check in on where you are and what kind of you know vacations you need to make sure that you're still there, primarily for the patients and then, for the younger nurses. I think that the younger nurses we have now where I'm working, they are very interested in what we have done and our history. I think, just being gentle and patient as they learn this field, and I think we're going to really see a great new generation of oncology nurses. So I think it's very important to answer your question directly that, as mentors, we are nurturing.
Cheryl
25:12
Yeah, and it's a partnership, honestly.
Gina
25:14
It is a partnership, absolutely yeah.
Cheryl
25:16
So, before we wrap up, I just wanted to ask you. You mentioned that you reserve Fridays for writing. What are you working on now? What are you writing?
Gina
25:32
I'm writing a novel now, and this novel came out of our Fort Monroe here. The first time I went to Fort Monroe a few years back and started reading about the contrabands inside Fort Monroe. These were the enslaved here in Virginia and North Carolina who wanted to be granted free status and Fort Monroe stayed within the hands of the Union as the Civil War erupted. So I thought, okay, that's great, I'll do that. But like I want to, I want to do this with nurses. So I'm focusing on that and it's in a letter form, as we call it, epistolary form. These original contraband women came in and were trained as nurses, because in the war, like all the wounded, started coming in. And I have them connected to the present day through two nurses in particular who were COVID nurses and one of them was an oncology nurse. So it's exploring, certainly nursing back then to now and also race relations in the United States and how that impacts nursing too.
Cheryl
26:28
Well, I love that you're the voice for nurses, for oncology nurses in particular, in this case. Gina Bright, thank you so much for joining us today, sharing your story, and providing support for the people who read your books.
Gina
26:42
Thank you so much for having me.
26:50
That's all for this episode of Cancer Care Connections. Join us in 2025 as we continue to bring you insights into the ever-changing landscape of patient care as it relates to cancer. We will further explore the evolution of treatment options and provide stories of hope as more people are surviving cancer today. We want to thank you all for listening and wish everyone a happy and healthy holiday. The holiday season can be a stressful time of year for just about anyone. If you are in need of strategies for combating stress during the holiday season, take a listen to our podcast episode "Navigating the Holiday Season with a Cancer Diagnosis." Let's not forget to appreciate the moments, lean on our support systems, and keep open lines of communication with our healthcare team and families.
Don't forget to subscribe to our podcast via Apple Podcast, Spotify or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com. Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com or find us on Facebook or Instagram at Virginia Oncology Associates.