Yesterday as I sat in a comfortable reclining chair at the Presbyterian Hospital in Huntersville, North Carolina while receiving my bi-weekly infusions my mind flashed back to 2008 when my late husband received his own infusions at King Faisal Cancer Center in Riyadh. The general process of receiving an infusion was the same but it was the approach and atmosphere that stood out in stark difference.
Since my diagnosis of Stage IV metastatic breast cancer I must receive regular bi-weekly infusions of medications in addition to taking other medications by mouth. To make it easier and less 
stressful on my body to receive the infusions, a power port has been implanted underneath the skin in my arm. As a result, I no longer need to be stuck with needles whether it is to draw blood or to give me an infusion of medication via an IV.
Abdullah also had a port to facilitate receipt of his own infusions, drawing of blood and for administration of chemotherapy. His port was called a hickman line. The catheter was implanted 
surgically under the skin but with the hickman line, the “caps” where meds were inserted remained visible outside of his body. The hickman line is not as commonly used in the United States and requires additional care and precautions to avoid infections.
When I receive my infusions the atmosphere in the Infusion Unit is relaxing, friendly and comfortable. Each patient is taken to a spacious room which holds two comfortable recliner chairs, adjustable tray on wheels for personal items, television and wireless internet. Patients are encouraged to have a caregiver or friend with them for company. Chairs are available for the caregiver and friend. Depending on how busy the unit is the caregiver may use the second recliner chair. If it is a busy day, two patients will receive treatment side by side in one room. However if a patient desires privacy, a curtain can be drawn which separates the two patients. For patients who may be weak and uncomfortable in a reclining chair there is a separate room which holds two beds and accompanying chairs for caregivers.
At the King Faisal Cancer Center patients receiving infusions on an outpatient basis first check in either at the men or the women counter depending on gender of the patient. The patient is also encouraged to have a family member present but in most cases the family member is of the same gender as the patient. Instead of separate rooms with comfortable chairs and amenities for patients, the outpatient infusion unit is a “ward like” atmosphere. The unit is comprised of rows of beds separated by high tall opaque curtains. There are no televisions or wireless internet amenities. Male patients receive infusions at one end of the unit and female patients receive their infusions at the other end of the unit.
A cancer patient’s infusion on an outpatient basis can take as little as 10 minutes to as long as ten hours. My experience as a patient at Presbyterian Hospital in Huntersville is that the staff and a team of volunteers do all they can to make the experience pleasant and comfortable. Patients are offered refreshments on arrival and after their infusions have begun are given a menu for a complimentary meal. The nursing team is professional and friendly. Volunteers will come and check on patients throughout their infusion offering warm blankets, magazines or simply to sit and chat.
By comparison the infusion unit in Riyadh was a quiet and somber atmosphere. Patients did not intermingle or talk to 
one another. They remained aloof from each other. The patient and caregiver may chat in quiet somber tones with one another. Usually the sounds one would hear penetrating through the opaque curtain were voices reading from the Quran. A nurse would check occasionally on the patient; there were no volunteers. The patient would be offered water or juice but the caregiver would usually bring home-cooked food for the patient to eat.
During my bi-weekly infusions at Presbyterian Hospital I interact with other patients. We share about our feelings and challenges of living life with cancer. We support each other and learn from each other. Such outreach is missing in Saudi Arabia. There are the invisible barriers in place which are not crossed. It seems expected that a Saudi will bear cancer stoically and quietly.
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