Carissa Outen crossed one of many self-designated finish lines Saturday when she graduated from North Central High School.
The 18-year-old has been fighting her second battle with a rare form of cancer at the same time she finishes her senior year. Her most cherished dreams are to do the things most students do in that memorable time: go to the prom, walk in graduation, receive her diploma.
“Cancer was not supposed to be here for her senior year,” said Britnee Outen, Carissa’s older sister. “… But she kicked butt. She made it through.”
Not only did Carissa attend the prom and make the much-anticipated walk despite numerous cancer treatments, she also led her classmates in their final act as high school seniors – switching over their tassels.
When Steve Gering, North Central’s principal, spoke of students he cannot forget, Carissa’s story of “hope and determination” was the one that made his voice quiver with emotion.
“If I could just capture what you have in a bottle and give it to others … the world would be a better place,” he said.
The entire auditorium at the INB Performing Arts Center was brought to their feet in a standing ovation for the teen.
Carissa was diagnosed in July 2008 with follicular lymphoma – one of 100 known cases worldwide in people younger than 19. The cells disappeared after six months of chemotherapy, and doctors told her to expect the cancer to be in remission for at least seven years.
On Feb. 19, Carissa and her family learned the cancer was back – at stage 4, the most severe.
This time, medical professionals hope to knock out the cancer with a stem-cell transplant. This week, Carissa and her mother, Gwen Ashcraft, will go to the Seattle Cancer Care Alliance – a collaboration of Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Children’s Hospital – to continue treatment.
But it’s hard to tell the teen’s life is filled with worry and uncertainty, even as she spends some of her days and nights in the Providence Sacred Heart Children’s Hospital oncology ward.
Carissa “shrugs it off like it’s nothing. To her, this is just another step we need to take,” Britnee said. One day Carissa told her, “You know, B? Sometimes I just don’t feel like I’m sick, and I don’t realize it until my hair starts falling out.”
Denise Miller, Carissa’s godmother, adds, “When you are in the presence of uncommon courage, you know it. I’ve felt that since the beginning of this journey.”
Chemo one day, prom the next
When Carissa found out her cancer had returned, keeping her hair until the prom was one of those little finish lines.
She made it, but just barely.
“I wanted a messy, curly thing,” Carissa said. “I wanted an updo.”
When her hair appointment came on prom day, April 24, she was prepared with a picture of Paris Hilton sporting the hairstyle she’d planned.
“I didn’t want it because it was Paris Hilton,” she said. “It just happened to be on Paris Hilton’s head.”
That day her head of hair was full, her energy up and her prom plans on schedule, despite the previous day’s round of chemotherapy.
Generosity from the Spokane community helped make sure the teen’s prom was memorable. Her “pediatric oncology family” at Sacred Heart paid for a suite at the Davenport Hotel Tower. Anonymous donors provided limousine service and her bejeweled navy blue prom dress. The Melting Pot provided her and her friends a free dinner.
But her high school classmates had a final surprise at the dance: They voted Carissa prom queen.
“It was one of those things where you don’t care if you get it, so it’s no big deal. But it was really cool,” Carissa said. “What was even cooler was one of my really good friends was voted prom king.”
Less than two weeks later, Carissa’s hair started coming out in clumps.
“It happens fast,” she said. “That’s what happened last time, too. I could drag a brush through my hair three times and the toilet would be full of hair.”
And like last time, the teen had her head shaved, bringing an entourage along to the hair salon for support. They cried, but Carissa reassured her supporters she was fine.
“I feel comfortable making sure everybody else is OK,” she said. “It’s hard for me to care about myself first. I think that’s how it is with everyone in my family. We got it from watching my mom.”
Ashcraft has been a single mother for a decade, since Carissa’s father died of colon cancer. He was 40.
“Cancer has us sort of freaked out,” Britnee said. “It took our dad and now it is going after my best friend.”
Chemo worse this time around
During her second round of chemotherapy, Carissa gave a co-worker from Albertsons a tour around the oncology floor like it was her own apartment.
“This is the teen lounge. … I had one of my senior pictures taken there. … Here’s the boat. … These are the fishes,” she explained to Jami Jobes while dragging along a rolling IV bag. “This is a good view of the city.”
The children’s cancer unit is painted in a beach theme. It was inspired by a patient, said Nettie Welshons, a hospital social worker. When the unit was being built, “they asked a teen undergoing chemo treatment what it was like,” Welshons said.
Not like a day at the beach, he replied.
Families who spend time there likely feel the same, but Ashcraft and her other daughters, Britnee and Heather Maynard, try to avoid tears.
Those closest to Carissa say this round of treatment has been rougher for her. The chemotherapy regimen involves six hours Friday, four hours Sunday and 24 hours of a steady drip on Monday.
“Compared to last time, when I had 19 hours of chemo and I could literally just unplug and go do whatever I wanted, this was hard,” she said. “I’ve been terribly nauseous, extremely exhausted. It was just not good.”
After each round, Carissa stayed home from school about a week to recover. She worked with a tutor to stay current on her classes, going to school when she felt up to it.
“I have been going to school semi-regularly for the most part, but I’m a senior and it’s the end of the year and nobody cares – or at least I’d like to think so,” she said.
The intense chemotherapy was meant to create temporary remission so stem cells could be harvested. A week before graduation, doctors called Carissa back to the hospital to collect the cells, which will be transplanted after a couple more radiation and chemotherapy treatments in Seattle. The procedure is scheduled for late July, followed by at least 10 days of isolation.
“I can handle being alone. Being alone alone is completely different,” she said.
Medically the family knows what’s planned, but physically and emotionally the prospects are frightening.
‘How do you thank them?’
One day last month when Carissa went to work at Albertsons, a regular customer gave her an “inspiration bag.”
Inside were a brown leather bracelet with “Courage” etched on a metal plate; a comic of a person slaying a dragon; a napkin with holy water; and a letter about the woman’s own battle with cancer.
The gesture is just one example of the kindness and generosity that have touched Carissa and her family in the last few months.
After learning of the teen’s struggle in a Spokesman-Review story March 14, people from as far away as New York reached out to help.
Carissa’s mother will take a leave from her job at the Spokane County Jail and temporarily relocate to Seattle to be with her daughter during treatment. The family has medical insurance, but lodging, food and other costs aren’t covered.
In response, people ordered T-shirts designed by Carissa and sent donations. Some wanted to target specific uses for the money, such as her prom. Most chose to remain anonymous.
An elderly couple whose son graduated from North Central and died of cancer two years later donated $1,000. The same amount came from another couple in the oncology unit with their own child.
The owner of a manufacturing company offered to help with transportation to and from Seattle, pay for accommodations while Carissa and her mother are there, and have a hand in the teen’s college tuition.
A medical assistant class at Spokane Community College held a fundraiser and donated the money. Mamma Mia’s restaurant and Taco Time, both on West Francis Avenue, donated a portion of their proceeds.
North Central High School led numerous events, raising nearly $10,000.
“The donations have been wonderful,” Ashcraft said. “They’ve made sure we have no worries in Seattle.”
Steve Fisk, a North Central assistant principal, has helped with the fundraising.
“I’m impressed with the fact that no one has flinched at all. In these difficult economic times it’s not easy to give, but people haven’t hesitated,” Fisk said.
Carissa said the support is wonderful, but asked, “How do you thank them? People are doing so much. I feel like I need to do something, but what do you do?”
The future is what concerns Fisk.
“This is going to be a lifelong journey,” he said. “I hope this is a reminder to all of us. Keep these folks in our thoughts.”
One more finish line
“I got into Gonzaga,” Carissa said – a goal since early childhood.
But with all that’s happening, she will wait a year before starting college. She plans to work and “sort of do whatever I want,” including some travel. Carissa would like to visit England.
At Gonzaga, she’s not sure what she’s going to study, but it will be “nursing or business. I’ll get through this first, then I’ll figure it out.”
Because Carissa is always looking ahead to the next finish line.