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Nicole Giamanco

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Patient returns as medical student

Nicole Giamanco, a third-year Saint Louis University medical student, was approaching the end of a two-week rotation in pediatric plastic surgery at SSM Cardinal Glennon Children’s Medical Center. By coincidence, it was January 25 — the tenth anniversary of her first admission to the very same hospital as a 14-year-old cancer patient.

“I was very sick,” Giamanco said. “I was at St. Joseph’s West Hospital in St. Charles County and they sent the transport team out to get me.

“While I was at St. Joseph’s they got me hooked up to IVs. Then a nurse came in and asked me if I knew what leukemia was. The first words out of my mouth were, ‘I’m going to die.’”

Giamanco was diagnosed with a rare form of leukemia, a malignant cancer of the bone marrow and blood. She recalls that she had been tired and run down for two months before a diagnosis was made.

“I was old for a kid with leukemia, and they caught it very late. I had a rare kind of leukemia, so they had to figure out what to do with me,” she said. “When I started, I had the whole oncology team taking care of me. They consulted with people across the country.”

Giamanco’s first hospitalization at Glennon lasted 53 days, much of it in intensive care. She received high doses of chemotherapy in a regimen that combined the treatments for adult and childhood forms of leukemia. Three times she had to be resuscitated when her heart began fibrillating.

“They didn’t have to shock me. They treated me with medications and I always came back. One time it took three minutes. I was about as close as you can get to not being around any more,” she said.

During her first hospitalization, Giamanco’s weight declined to 53 pounds. “When I was in the intensive care unit, I had IV pumps labeled ‘A’ through ‘J.’

Gordon Gale, M.D., a member of the division of hematology and oncology at Glennon, was staffing the intensive care unit when Giamanco arrived there.

“He saved my life and became my permanent oncologist,” she said. “Basically, he got stuck with me for life. I attribute my survival to Dr. Gale and the staff here. He canceled his vacation when I was in the intensive care unit to stay and take care of me. That dedication is the reason I love this place and why this is what I want to do with my life.”

Giamanco’s chemotherapy treatments continued more than two years, until April of 1997. She continued to visit the hospital for follow-up exams and volunteered for five years as the Candlelighters Childhood Cancer Society teen coordinator at Glennon. When it was time to transfer the hematology and oncology department to the new Bob Costas Cancer Center, Giamanco moved all the patients’ toys and games from the old clinic space in the north end of the hospital.

Even before her hospitalization, Giamanco had wanted to be a doctor. “I really have no idea why. There is nobody in my family in the medical field, and I had no medical history, except for a couple of stitches in my chin, prior to my leukemia. I never had any idea what kind of a doctor I wanted to be until I came here.”

Giamanco will do a longer rotation in pediatrics at Glennon later this spring. She finds it exciting to return to Glennon and many of the doctors and nurses who cared for her a decade ago. In addition to Gale, her team included Albert Chu, M.D., Dennis O’Connor, M.D., and Patricia Codden, R.N., of the hematology/oncology division, as well as Costas Center receptionist Mickey Ennis.

“This is such a wonderful place that people like being here and stay for 20 or more years,” she said.

After her fourth year of medical school, she will do three years of pediatric residency and three years of fellowship in pediatric hematology and oncology. She is attending medical school on a U.S. Army scholarship, so her training and at least five additional years of service could take place in military hospitals.
Her Glennon experiences guided her career to pediatrics.

“That was my first realization of the differences and philosophy of pediatrics,” Giamanco said. “In pediatrics, I think people cater so much more to the patient’s comfort and to the family. They do care, and they do take time.”

After her Army career is over, Giamanco would like to return to Glennon. Until then, she believes her experiences in the hospital will make her a better doctor and a hopeful symbol to her patients.

“When I was volunteering in the Costas Center, sometimes the doctors or nurses would ask me to talk to the newly-diagnosed families,” she said. “When they found out that I went through what they are going through, I think it really connected with them. They realized I was treated here and made it, so their kid can, too. I could see the glimmer of hope in their eyes. I really like that.”