In memoriam: Sonya Nelthropp

My friend Sonya Nelthropp died this week on her beloved island of St. Thomas. I received the news while in Holland, but have not had a quiet moment until now, as I write this onboard my flight back to Boston. Hardly any of you, dear readers, knew Sonya. But may I ask you to read on anyway, for two reasons? First, there are aspects of her story that will resonate with many of you, and will move some of you. Second, for my own selfish reasons, I want you to feel that you know her, so you can join me in missing her. This is longer than usual, so please bear with me.

The St. Croix newspaper printed this obituary. It is accurate and gives hints of an unordinary life. It starts with her teaching science at the local high school in Charlotte Amalie. Then, what’s this about going to school to be a seaman engineer in the merchant marine, one of very, very few women to so do? And, then a change of heart to get a master’s degree in education at Harvard? Then, a stint helping to train people to run the sewage treatment plant in Boston Harbor? (That’s where we met.) Then, a return to St. Thomas to be the force behind setting up the Virgin Islands wastewater management authority. And, then dying at age 62.

Let me fill in some details, starting near the end. In the winter of 2010, when I was still CEO of Beth Israel Deaconess Medical Center, Sonya called me to say she was in Boston for some tests. Biopsy results received on a Friday afternoon indicated two forms of cancer. She was in a turmoil. The people at one of Boston’s most distinguished cancer centers had given her this verdict and then told her they would set her up to meet with a medical oncologist in ten days.

Ten days? You give a woman test results showing two forms of serious cancer; she is over a thousand miles from home, staying alone in a hotel; and the best you can do is get her an appointment ten days hence? It is hard to imagine a more cruel act. We had dinner the next night, and she told me the story. I said, “We will do better for you.” I took her medical records and sent an email at 10 pm that night to several doctors at BIDMC, asking them to think about how we could help.

I called Sonya the next day, Sunday, at about 1pm, saying that someone was likely to be in touch. She replied, “Dr. Awtrey [our gynecological oncologist] already called me. He spent two hours on the phone with me this morning telling me what to expect and possibilities for treatment and promising to coordinate my care with the other departments. His secretary will pick up my medical records from your office tomorrow morning.”

The next morning, Chris Awtrey’s secretary came by the office, and I asked her to express my appreciation to him for reaching out to Sonya on a Sunday. She looked at me with great seriousness and said, “Oh, there is no reason to thank him. Dr. Awtrey believes that the most important part of his job -- before performing any treatment -- is to spend as much time as necessary with a woman to help her be less anxious about her disease. That is the way he is. I can’t think of a more admirable person. It is such a privilege to work with him.”

Over the following weeks, the BIDMC team went to work -- surgery, radiation, chemotherapy. All aspects of care were well coordinated among several departments, leaving Sonya feeling like a queen. She understood that they had bought her some time, probably not a lot of time, but she was tremendously grateful for all that had been done. She was even more grateful for the degree of humanity shown to her by the doctors, nurses, radiation therapists, transporters, food service workers, and others during her stints as an in-patient and out-patient.

She went back home to the islands, undertaking follow-up care as needed, and then returned to BIDMC for a check-up in August of 2011. “The PET scan lit up like a Christmas tree,” she reported to me. “They’ve told me I have six months to a year to live. I might be able to extend it by a month or two with chemotherapy, but I don’t want to live that way. I’m just going to go home to St. Thomas and live well till the end.”

I went to visit her twice, once in November and again in January. We had a ball, touring St. Thomas, looking at places where our relatives might have known each other, accompanying me as I bought custom made sandals at Zora’s, heading to beautiful beaches (her to read, me to swim), playing backgammon, relishing in killing mosquitoes with an electric swatter, playing with the dogs, eating well and, yes, drinking well, too!

We talked plainly and openly about end-of-life issues. I expressed concern about her being far from her closest friends and family, who live in the US. Would she want to have hospice care at my house in Boston, or elsewhere near to people who could help out. We sat discussing this on her balcony: “How can I leave this?” she said, pointing out over the sparkling water, the neighboring islands, and the vegetation, as birds and peeper frogs sang in the background. “This is paradise. This is my home.” And so she stayed.

Sonya was immensely proud of her late parents. They were a tremendous influence in her life. She showed me items from the family archives, and I translated some of them into this blog post about her father. Unlike her mother, who had died fairly recently and whose obituary was in the online edition of the local newspaper, her father had died before the Internet, and so there were no images of him to be found on the web. I published a picture of him and her in my blog post. The next morning, I said, “Look at this!” I had done a Google image search, and the photograph of her father and her was already available for the world to see.

Not being very savvy in the ways of social media, she gasped, “That’s amazing. How did that happen, and so quickly!” Mainly, though, she was so grateful that I had told his story in a setting that could be seen widely by others.

A bit about that stint as a cadet in the merchant marine. Why Sonya wanted to be a seaman engineer was a simple, “I thought it would be interesting.” Why did she stop? “I was on a training cruise in the Suez. A fuel leaked developed in a diesel engine. As the cadet, I had the least seniority, so I was assigned to go under the engine and repair the leak. I had to lie on my back fixing the problem with a welder. It was 140 degrees under there. I finished the task and realized that I never wanted to do anything like that again. When I got back to port, I shipped out and figured it was time to get back to teaching and applied to Harvard for the master’s program in education. I never looked back.”

We went through dozens of file folders from her drawers, and she piled stuff about her life and her family in my suitcase. She gave me her stamp collection (another common interest): “I won’t be needing these.” She offered me her old leather backgammon set. “I’ll leave this here,” I said, “so we can play the next time.” “Right,” she said, with a wry grin. That was our private joke. We knew there would not be a next time. I would be off traveling for several weeks, and we both knew that the odds would work against another time together.

I called Sonya a few times in the following weeks. Her breathing had become difficult as the tumors spread and grew into her lungs. She added morphine to her daily routine. Then she added an oxygen generator. I shortened the phone calls because I knew it was hard for her to talk. The call I knew would be the last was a day or two before I left for Iceland and Holland on March 25. When you have worked in a hospital, you know when the end is near. She knew, too, and we hugged across the phone lines and expressed our love and our gratitude for the times we had had together.

I end with a poem Sonya wrote while a cadet in the merchant marine. It is about being assigned to be on watch. But being just a cadet, there also had to be a certified seaman on watch. So, as a cadet, you “watched the watch.” Here it is, the product of a young woman who lived a short life to the fullest.

A Cadet's First Watch

What do you do on your first watch?

You watch the watch
Who watches the gauges
and watches the pumps.
You watch the watch, watch his watch.

What do you do on your first watch?

You watch the wipers
You watch the DEMAC
You watch the watch, then you watch your watch.

What do you do near the end of watch?

You watch the watch
Fill in the log
Put up the coffee cups
Stretch his legs
And watch the ladder for the next watch.