By Kyla Dunn
Caring for the Whole Person
Thirty years ago, psychiatrist Jimmie Holland started a revolution around an idea: Health professionals need to treat the painful emotions associated with cancer, not just the disease
By Kyla Dunn
At 80, psychiatrist Jimmie Holland has never had cancer, but the disease has nonetheless cut deep wounds in her life. She lost a 3-year-old grandson to a rare liver tumor, and a daughter-in-law, age 38, to lung cancer. “Never smoked a day in her life,” Holland says, quietly. “She left two little kids, which is very sad.” If resources are readily available to help patients and their families cope with this kind of sadness, and with other psychological burdens raised by cancer, it is because Holland herself made certain of it. Thirty years ago, she founded a new subspecialty in cancer medicine—known today as psycho-oncology. It focuses on the human side of cancer, defining the typical emotional struggles that arise and the kinds of support that can best help people through them. Often, this means treating acute depression, anxiety or panic that can prevent patients from following through on their course of therapy.
All her life, Holland has witnessed adversity. She grew up on a struggling family farm, in rural Texas, amid the Great Depression and World War II, raised by parents who didn’t finish high school. Although she had never heard of a woman doctor, she resolved to become like her family’s local doctor—and eventually attended Baylor University College of Medicine in Houston. Soon after graduation, however, she discovered that she was most fascinated not by physical illness itself, but by how people coped. “You could take 10 people with exactly the same medical diagnosis, and they were extraordinarily different in how they were dealing with it, and how much it impacted their lives,” she explains. “I would get very involved in their stories, and always found that more interesting than managing their blood pressure.”
As a result, Holland chose to become a psychiatrist. She began her psychiatry residency in St. Louis but moved to Massachusetts General Hospital, in Boston, after the trauma of her first husband’s suicide. She arrived in the midst of the devastating 1955 polio epidemic. “We had people coming in paralyzed from the neck down who had to go into the big iron lungs,” Holland recalls. She began studying these patients, asking the type of questions that would define her career: “How do you adapt? How do you manage? How do you deal with being healthy one day and totally paralyzed the next?”
Around the same time, she met her second husband, James Holland, then the chief of medicine at Roswell Park Cancer Institute, in Buffalo, N.Y. They married in 1956, and settled in Buffalo to raise the large family (totaling six children) that Holland, an only child, had always wanted. While her children were young, Holland worked part time as a psychiatrist, helping patients with life-threatening diseases grapple with depression, anxiety or mental illness. As she and her husband discussed their work, her interest in his cancer patients grew. “If you really wanted to understand how people react to illness, you couldn’t have a better model to study than cancer,” Holland says. “So I vowed when the kids were a little bigger that’s what I’d do.”