ENTERPRISE — The news wasn’t completely unexpected for Nils Christoffersen, but that didn’t make it any easier to hear.

Christoffersen, the executive director of the Enterprise-based nonprofit organization Wallowa Resources, had known for years that he had risk factors for multiple myeloma, a cancer that forms in white blood cells. A routine checkup several years ago revealed those risk factors, and so his medical providers started regularly checking for signs of the disease.

Three years ago, Christoffersen was officially diagnosed with multiple myeloma — but he was asymptomatic, in what medical professionals term (in a not particularly reassuring turn of phrase) “smoldering myeloma.” The monitoring stepped up, with quarterly blood tests, annual bone-marrow biopsies and full-body CT scans to watch for symptoms such as bone lesions. (Fueling some of the concern was the fact that Christoffersen’s mother, Rebecca, had died of multiple myeloma in 2007.)

Some multiple myeloma patients never show symptoms, Christoffersen said, and the longer patients remain asymptomatic, the greater the chances are that the disease never will emerge from its “smoldering” phase.

But earlier this year, the CT scan picked up a bone lesion.

The disease was no longer “smoldering.” Christoffesen started chemotherapy at Wallowa Memorial Hospital’s oncology clinic in July.

The treatment was successful. In the words of one medical professional, it prompted a “glorious response.” And last week, just in time for Thanksgiving, Christoffersen marked the end of the treatment by ringing a recently installed chemo bell at the hospital. The idea is that a cancer patient can ring the bell to mark the end of their therapy.

He wasn’t the first one to ring the bell — that honor went to Robin Martin, a local cancer survivor who rang it during its official dedication on Oct. 2, 2023. The 58-year-old Christoffersen was, however, the first person to ring the bell after finishing his treatment at Wallowa Memorial.

For both, ringing the bell was memorable.

With the exception of online consultations with Dr. Rebecca Silbermann, a specialist in multiple myeloma at Portland’s Oregon Health & Science University, Christoffersen’s treatment was all handled locally — and that was among his thoughts as he rang the ball last week:

“This was just incredible for me to be able to do this all so locally, with such a great team of providers,” he said.

Martin was a little bit taken aback when she rang the bell.

“Until I actually rang the bell — 35 years since my first diagnosis with breast cancer — I was unaware of how much the action would mean to me,” Martin wrote in an email. “I was 37 years old when I was first diagnosed and I just turned 72. Incredible to still be alive, but it has not been an easy journey.”

The chemo bell

The MD Anderson Cancer Center at the University of Texas claims it was the first medical facility to install a bell for cancer patients to ring, back in 1996.

The story at Anderson is that the bell was inspired by a rear admiral in the U.S. Navy who was undergoing radiation therapy for head and neck cancer. The admiral told his doctor that it was Navy tradition to ring a bell when a job was done. So he brought a brass bell to his last treatment, rang it several times and left it behind as a donation. The bell eventually was mounted on a wall at the facility — and the idea has spread throughout the nation.

A Wallowa County breast cancer support group, the Breast Warriors, got the idea that Wallowa Memorial needed a bell of its own and got about raising the roughly $350 required to purchase it.

Katie Weller, a family nurse practitioner at Wallowa Memorial’s clinics and a member of the Breast Warriors, searched the internet for pictures of chemo bells and other members of the group contributed ideas and photos of their own bells.

The inscription on the bell’s plaque reads: “Ring this bell three times well to celebrate this day. This course is run, my treatment done, now I am on my way.”

Ringing the bell is a symbolic act, Weller said, but it marks an important milestone for any cancer patient.

“I personally think it’s very important that no matter what your journey of your cancer is, or what your outcome looks like, it’s the fact that that part of your journey is done,” she said. “It shows that you fought hard to do all you could to beat this. Because chemo isn’t easy.”

In fact, “fighting” is one of the four principles of the Breast Warriors support group, she said, along with family, faith and friends.

Weller is proud that the Breast Warriors is one of the few cancer support groups active in small towns throughout Eastern Oregon — and that tells her something about Wallowa County.

“That’s something I’m very thankful for,” she said. “I mean, I’m a medical provider, but as a breast cancer survivor, it’s so remarkable that in a small town, not only do we have amazing health care in general, but we have a community that cares so much. It’s huge.”

Making connections

For his part, Christoffersen knows that chemotherapy isn’t easy — he suffered various side effects during his weeks of treatments, but the worst one for him was an overall decline in energy.

“It was mostly just a slow, gradual deterioration of energy and then, some days when it was harder to concentrate and really be productive,” he said. “On those days, I would just go home early and go to sleep or rest. … That was very challenging for me. Because I don’t like sitting around. I like doing things.”

But he is grateful for the medical providers — mostly entirely in Wallowa County — who accompanied him on his cancer journey.

Many times, he said, his treatments at Wallowa Memorial’s oncology clinic would take less than 20 minutes.

“The process for me has been incredibly efficient with everybody there,” he said.

The journey — and the ringing of the chemo bell — connected Christoffersen with a broader community of survivors.

“A lot of people are probably looking for support, and somebody to talk to who’s been through it,” he said. “I mean it’s not pleasant, to be honest with you: It changes your perspective on a lot of different things. It’s important that people are not isolated dealing with this.”

Martin had that community in mind when she rang the bell. Her cancer journey has been fraught with hurdles — a lumpectomy with both chemotherapy and radiation; a double mastectomy; failed reconstructive surgery.

“My treatments have led to many medical and psychological symptoms impacting my daily existence,” she said.

But ringing the bell for that first time was nothing less than joyous, she said.

“Upon ringing the bell and seeing the faces of my fellow survivors and supporters, I was overcome with joy for life and hope for the future.”

The Breast Warriors support group for breast cancer survivors meets the third Tuesday of every month at 6 p.m. in the conference room at Wallowa Memorial Hospital, 601 Medical Parkway in Enterprise. 

The Promise Study is the first study to test healthy people who may be at risk for early warning signs of a blood cancer called multiple myeloma — and it’s offering free screenings to African Americans or close family relatives of people with myeloma or its precursor conditions. For more information about the study, go to the website enroll.promisestudy.org.