Guardian Angel

Story by Chris Francis

When IWU nursing student and community leader Toni Tortorella ’21 was diagnosed with cancer, her family at home and school advocated for her health and her academic success. Now she’s a nurse at the hospital that cured her.

Toni Tortorella ’21 has a guardian angel in her necklace. Both because the necklace, given to her by her grandfather when she was a child, bears a relief of a cherub on a medallion made of gold from Colombia — her grandfather’s country of birth — and because it helped save her life.

The necklace bore special meaning for Toni’s grandfather as she was his first grandchild, and it has carried new meaning for Toni ever since her grandfather died shortly before she graduated from Maine South High School (MSHS) in her hometown of Park Ridge, Illinois. She wears it almost every day.

It was while completing a nursing clinical on a morning in October 2019 that Toni was playing with her necklace out of habit. Then she felt an odd lump at the base of her neck.

The lump was small and hard, and it didn’t move when pressed — everything that Toni’s courses and professors had taught her to suspect as signs that something was very wrong.

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As long as Toni can remember, she always said she wanted to be a doctor. At least until she realized that, “I didn’t want to go to school for the rest of my life.”

As she explored other options, she discovered that she enjoyed the more personal touch that being a nurse brought to caregiving. It helped that she got a hands-on opportunity to experience nursing as a profession thanks to MSHS, which offers a certified nursing assistant (CNA) course. As a high school senior, she became a CNA during the 2016-2017 school year and discovered that her instincts were correct. She would love being a nurse.

When it came time to decide where she would go to college, the Illinois Wesleyan nursing program was an obvious draw, but she was also interested in continuing to play softball. Where her other options told her that it wouldn’t be possible to do both, the IWU softball coaches wanted to recruit her as an infield utility, but they also wanted her to become a nurse, while the nursing faculty wanted her to keep playing. Thanks to that understanding, Toni knew then that she had found her alma mater.

“If I ever had a test our coaches would say, ‘Absolutely, study for your test. You can leave practice early,’” she said. Vice-versa, if she had a game that conflicted with a nursing clinical, her instructors would reschedule it for her to make sure she could join the team.

Not to mention, she was Vice President of Membership at Kappa Kappa Gamma, a nursing lab assistant, and she minored in Hispanic studies. Toni always set high standards for herself, almost a perfectionist, and Illinois Wesleyan made sure she could meet those standards.

“Toni was engaging, not only in the classroom but out on campus. She was seen as a leader among her peers,” said Associate Professor Noel Kerr, Toni’s fall 2019 clinical instructor.

But what most enabled her was the attention that the nursing faculty gave to her studies and to her as a person buried by responsibilities.

“My freshman year I was struggling very badly, but I still have a picture in my phone of the email I sent to my advisor, Dr. (Amanda) Hopkins. It was 11 o’clock at night, and I told her ‘I am struggling. I don’t know what to do.’ And the very next day she and Dr. (Vickie) Folse met with me, and they told me, ‘We know you’re putting in the effort and that you care, and we’re going to do everything in our power to help you,’” Toni said.

“Every week she showed up enthusiastic, and that enthusiasm helped us be more willing to give her opportunities,” said Assistant Professor Lydia Bertschi.

They and Toni understood that nursing is a profession with incredible demands that no one can hope to meet without help. “I was not a straight-A student. I had to work hard,” Toni said. She found resilience in her community.

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That October morning, when Toni felt a lump in her neck, she was lucky to be in the same room as one of those instructors who had her back. The nursing faculty aren’t in a position to diagnose students as their doctors, but when Toni asked Kerr what she thought, Kerr told her to get it checked out.

The doctor she saw in Bloomington wasn’t concerned. Toni was told that it was most likely some inflammation that would go away, and she should take ibuprofen to help it along. For a week she took the prescribed doses of painkiller, but the lump remained.

Toni had suspected that this wasn’t a simple case of random inflammation, and the failed treatment convinced her even further, so she went back to someone else she trusted. She asked Becky Altic, a retired nurse and former laboratory associate with the School of Nursing, what she thought of the situation. When Becky felt the lump on Toni’s neck, the look on her face alone confirmed that Toni needed a second opinion.

The second opinion came from her pediatrician, whom her family had long trusted as a friend who would make time to see Toni during her Thanksgiving break. The pediatrician told her that the lump itself wasn’t anything remarkable, but he understood her concern and referred her to an ear, nose and throat (ENT) specialist at Lutheran General Hospital in Park Ridge. The specialist there was also not alarmed.

Which, to be fair, Toni explained that, “The first day I felt it, I said to my friends, ‘What if I have cancer?’ and they told me to not worry. I was just being dramatic. And I am kind of a hypochondriac. It could be cancer, but it would more likely be a thyroglossal cyst. There are just so many things in your neck that something like that could be.”

The ENT decided to perform an ultrasound after Toni’s fall semester ended just to be sure. It confirmed that the lump was a lymph node that had perhaps become cystic. But beside the lump was a miniscule spot on her thyroid — not even big enough to warrant a biopsy, but curious enough to prompt the doctor to perform a biopsy on the lymph node before Toni went home to wait for the results.

Around five in the afternoon the day before Christmas Eve, Toni still hadn’t gotten a call, and she had mentally logged that this was closing time for their office. If they weren’t in a rush to give her any news before Christmas, she figured she shouldn’t be worried about whatever they found. So she went to visit her boyfriend and his family about an hour away from home.

After she arrived, she finally got a call. She answered the phone around seven in the evening to hear a doctor ask if he was speaking to Toni. After she confirmed, he delivered the news.

“It was extremely malignant,” Toni remembered. “I was horrified.” But she had learned through her training as a nurse that the most important question to answer was which of her cells had become cancerous. Was it thyroid cancer? Or was it lymphoma?

The doctor said that they believed it was thyroid cancer that had spread to her lymph nodes, thus creating the lump she felt when playing with her necklace.

“At this point, I didn’t know much about thyroid cancer, but you’re told you have cancer, you’re told it’s spread to your lymph nodes, and you automatically assume you’re going to die,” she said. She was terrified, and far from home, but, thankfully, she was close with her boyfriend’s family who knew how to respond to the news. Her boyfriend’s dad had cancer as well. “He was able to tell me that he’s there for me, and we’re in this fight together. Where my parents’ heads probably would have exploded. So, thinking back, everything happens for a reason.”

She did tell her parents that night after she drove home. As for whether their heads exploded, it was a conversation during which Toni, as far as she can remember, blacked out.

The next morning they learned that they wouldn’t be able to meet with the Lutheran General team again until the next week as they were off for Christmas. Toni’s mom was livid, and a team member agreed to meet with them that day on Christmas Eve.

The cancer was treatable with surgery, they told Toni, and the doctors at Lutheran General were confident they could do it, but, to make sure they completely excised all cancerous lymph nodes, they would need to perform a cut going from the base of one ear, down to the center of the collarbone and returning to her other ear for a full dissection of her neck that would leave a conspicuous scar.

Of course Toni would happily take the scar in place of the cancer, but her time at Illinois Wesleyan had made her acutely aware of the stellar reputation of the operating room at Northwestern Memorial Hospital in Chicago. If she could choose anyone to perform this surgery, it would be there.

The problem was, so would everyone else, and the waitlist was extensive. They were told that they wouldn’t even be able to get a consultation until March of 2020. But Toni’s mom went to work again, writing a message pleading her daughter’s case as a young woman studying nursing and playing softball at Illinois Wesleyan. The surgeon, Dr. Dina Elaraj, wrote back agreeing to see Toni on December 26.

“The first thing she said to me was ‘you are going to be okay, and you will not have cancer after this surgery,’” Toni said. Elaraj explained the details. Of all the news Toni could have gotten immediately after the terror of her cancer diagnosis, the specifics explained by Elaraj were a best-case scenario. 
Papillary thyroid cancer, compared to lymphoma, is slow-growing and much more treatable, especially since discovering the lump had allowed Toni and her doctors to catch it relatively early. Elaraj suspected that Toni might have had it for as long as two years at that point, but it was still possible to cure her of the cancer through surgery alone.

The hopeful prognosis set Toni at ease, and, even better, she explained that they believed they could perform the neck dissection with only a small incision above her collarbone that would still leave a scar but a much less dramatic one.

“She’s just a badass,” as Toni likes to describe her.

Toni’s surgery took place on February 3, 2020 — just as the COVID-19 pandemic was making its way to the United States. Toni’s parents, who had been with her for every appointment since, slept in the hospital that night as she recovered. Following the surgery, she had no indication of any remaining cancer, and there hasn’t been a sign since. The only mark that remains is a scar at the base of her neck, just above where her childhood gift from her grandfather rests.

When asked if she felt like her grandfather had been looking out for her, she said, “Oh, yes. Absolutely.” There are few people she has trusted to take care of her as much as him.

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Toni was able to go from a horrifying diagnosis to a confidently hopeful plan over the course of a Christmas, but that didn’t stop the IWU nursing department from getting involved to give her the support she needed.

“Dr. Folse told me that, no matter what happened, they would make sure that I graduated on time with my class,” Toni said. Through softball games, KKG responsibilities, and a cancer diagnosis, she did so in spring 2021, and she was ready to enter her profession.

Ever since she began studying nursing, working at Northwestern was a dream of hers. Now she had come to learn how they care for their patients as if they were family. She had to be a part of it again, this time as a member of the team.

When Northwestern came to the Illinois Wesleyan nursing career fair, she spoke with the recruiters and began building a relationship. It helped that she had a powerful story to tell.

“I made one of them cry. She still remembers that,” Toni said. And when Northwestern was looking for a surgical nurse, she applied.

Normally an operating room prefers not to hire nurses straight out of school, though Northwestern has an OR nurse residency program for new graduates. But Bertschi and Folse made sure Toni was the first IWU student to have a perioperative senior clinical at BroMenn Medical Center. She had already been in the operating room, both as a patient and as a caregiver, and she was hired as a nurse in the Northwestern surgical department in August 2021.

“I love it. It’s awesome,” she said. “I’m part of some really cool groundbreaking surgeries, and I’m now teaching some new nurses myself, which is really fulfilling and rewarding.” The job is everything she dreamed it would be, as she tells her old instructors.

“Her life is blossoming,” said Kerr.

As for what’s next for Toni, “I don’t really know,” she said cheerfully. “When I got sick, I realized that you can’t plan your life. So I’m trying to be where my feet are.”

She would like to go back to school to perhaps become a nurse practitioner specializing in oncology, but post-cancer Toni has come to realize that “nothing else matters all that much if you’re not healthy and happy. Being busy with important things and meeting standards of being perfect isn’t worth it if you don’t have that.”