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Saturday, May 26, 2018
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Tom Jackson Columns

Jackson: O'Neil brings order to cancer's chaos

BAYONET POINT - Paula O'Neil is - by genetics, education and training - a planner, organizer and manager, one of those "a place for everything and everything in its place" people who, while probably annoying to live with, are invaluable when it comes to overseeing the efficient maintenance and routing of information - particularly of the sort that is local government's principle by-product.
O'Neil's preternatural gift for staying atop this relentless tsunami of official data is much of what makes her the quintessential clerk of court and county comptroller, a fact recognized by her peers when she was installed as president of Florida's clerks' association last month.
But it is her ability to enforce order on bureaucratic chaos, read endless county commissioner resolutions into the record and still find the energy to conduct a mass wedding each Valentine's Day without ever exposing a frazzled glance or getting her hair mussed that explains much of Pasco's affection for her.
So we have been watching, with equal measures of anxiety, well-wishes, prayers and rueful curiosity, how our local pillar of cheerful efficiency would respond to the diagnosis in May that she had breast cancer, a disease whose very nature is chaos.
To our relief (if not to our surprise) , here, too, O'Neil means to enforce order. A small example:
Monday, she endured a radical mastectomy, an 8-hour procedure at Moffitt Cancer Center from which she emerged alternately nauseated (from the anesthesia) or dizzy (from the intravenous morphine pump) or in miserable pain. Wednesday she was home, under the watchful eye of her older brother, Oklahoma City's Harry Smith, himself a colon cancer survivor, plus Buddy the dachshund and, on loan from her nephew, Louie the 50-pound mutt.
Thursday, O'Neil made an appearance via FaceTime, and to much good-natured scolding, at her Rotary Club's luncheon. And Friday, surrounded by well-arranged flowers, cards and books, she was propped in the newest addition to her family room, a doctor-mandated electric-powered chocolate brown recliner that does everything but freshen your Gatorade, applying perspective to her status for a couple of media visitors while fretting about her appearance.
"Do I look sick?" O'Neil says, fixing the photographer with a meaningful frown. "I don't want to look sick."
Let it be said, then, for the record, Pasco's county clerk does not look sick. She looks tired and in need of a little morning sun, perhaps. But sick? Not a chance. Because, she isn't. Monday morning, she rolled into the operating theater with a tumor (self-detected, by the way) boiling in her right breast. By Monday evening it was gone, along with the four lymph nodes that were feeding it. "I'm cancer-free," she says
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This early declaration scarcely rules out the likelihood of future precautionary measures, but the type and extent of those will hinge on news from the lab where tissue samples have been sent. If it comes to chemotherapy, she's already investigating a "chemo cold cap" designed to chill the scalp and reduce chemical uptake by the follicles. Says O'Neil, "I'd like to keep my hair."
She concedes there are worse things to worry about, and, early on, she did.
"When you first find out (you have cancer), it's all you can think about," O'Neil says. "It's with you all day, when you go to sleep, when you wake up in the morning."
In short, cancer - this awful, horrible, scary disease you never, ever thought would find you - becomes your world, and, even if you are a public figure who gets invited to all the cool parties, gets great seats at the best local events, rides in every parade and signs off on more than $1 billion in checks each year, you feel alone and helpless in it.
Even the upside has a downside. The doctors congratulate you for your vigilance. They tell you what you already know: Early detection is the key to a swift and successful resolution. They quote you glowing statistics to boost your spirits. But, early on when cancer frames every thought, dark ideas tug you toward the abyss. Even if 99 out of 100 patients with precisely your diagnosis survive, cancer commands you to focus on the one who didn't make it.
"But then you begin to learn about the process," O'Neil says, "and all that changes."
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You meet your teams of doctors - the cancer surgeon, the plastic surgeon, the oncologist - and once they lay out their interwoven strategies, cancer morphs, voila, from a nightmare disease to just another management challenge. Sort of like figuring out how to maintain a respectable level of constituent service despite the Legislature's annual budget squeezing.
It probably helped that, as a longtime participant in and the 2010 chairwoman of the annual Making Strides Against Breast Cancer rally, O'Neil got cancer even before she got cancer. Her initiation was through her mom, who was 52 when she succumbed. Later, galvanizing her point that "everyone knows someone who has been diagnosed with cancer," she came to know clerk's office employees who were stricken and survived, and others who did not.
With O'Neil's diagnosis, the circle grows larger still. Now, with her post-operative recovery - indeed, resurgence; she's eyeing an appearance at the July 23 county commission meeting - the sphere of those learning what it takes to survive and thrive into an efficient, orderly, and well-managed old age has a chance to expand, too.
And that would be, Madame Clerk? "Understand that life is precious. And ignoring cancer won't make it go away. Early detection is the key. ... It's all about early detection."
Make a note, but don't file it away. Stick it on a mirror. Type it into your smartphone calendar. Ask Pasco's top clerk. Early detection is one piece of data you don't stick in a folder.
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