BY THÉODEN JANES, as seen in the Charlotte Observer on Sunday, October 17, 2021
As a freshman, David Buckner embarked on his college career the way a lot of overachieving students do: with outsized ambition, eager to do the most exceptional work he could, then move on to the next phase of his life without looking back.
Then, last April, the UNC Charlotte nursing student wrote a paragraph-long, out-of-the-blue email to an associate professor of nursing named Maren Coffman -- a faculty member he'd never met and knew virtually nothing about -- seeking research opportunities for a project related to his prestigious scholarship.
His experience at UNC Charlotte hasn't been the same since.
Though he never would have imagined it working out this way, six months after receiving Coffman's reply, Buckner finds himself today with a uniquely powerful emotional connection to his project and its aim: to create a program that provides resources and support for the under-served population of individuals living with terminal breast cancer.
"I viewed the civic engagement project as being something I do during my undergrad, and when I'm gone, it's not my worry anymore," says the 19-year-old sophomore, who is pursuing a nursing career focused on women's health. "But this is something I see myself being involved with for a very, very, very long time."
He says he dreams of a day when he'll be making enough money that he can provide generous donations to help keep any programs that come out of this going.
More than anything else, though, he hopes, with all of his heart, that Coffman will live long enough to see their plans become a reality.
CANCER STRIKES, NOT ONCE BUT TWICE
The first time Coffman found out she had cancer, in 2014 -- the year after she'd been promoted from assistant professor to associate professor by UNC Charlotte -- it could have been a much more frightening diagnosis.
Doctors discovered she had ductal carcinoma in situ (also known as DCIS), which occurs when the cells lining the milk ducts become malignant, yet remain unable to get into either the lymph nodes or the blood stream. It's commonly referred to as Stage 0 breast cancer.
She had a lumpectomy, then a treatment regimen that included radiation and a five-year course of Tamoxifen, which blocks the effects of estrogen in breast tissue.
But when Coffman was down to her last bottle of Tamoxifen, she says she developed pain in her legs that became so excruciating she had difficulty walking. Then back pain. Then pelvic pain. Then she lost her hearing in one ear. She didn't ignore any of it; she went to see a doctor four times. Eventually, her skull started aching.
A brain MRI was ordered.
That led to the second time Coffman found out she had cancer, in 2019 -- by which point she'd become highly regarded as a researcher focused on Latino health and access to healthcare, having been inspired to do so by a year and a half of mission work in Venezuela as a young adult.
And this time the diagnosis couldn't have been scarier: Breast cancer had spread to bones throughout her body, as well as to several lymph nodes, to her liver, and to her brain.
Statistics vary, but generally speaking, women with metastatic breast cancer have roughly a 25 percent chance of living for five years.
It was devastating.
"Definitely anger at the beginning," recalls Coffman, when asked about her emotional state upon receiving the Stage IV diagnosis. "It was --" she stops herself, and sighs before continuing.
"This is when I get upset," she says. "But, anger that it hit me at the peak of my career. Anger that I may not see my children get married --" her voice starts to break "-- or have their first children. That I won't be there for them. So, anger, sadness."
She and her husband Brett have 20-year-old twin daughters at the University of South Carolina, and 15- and 12-year-old sons.
Maren Coffman is 51.
"And then once I was through some of that initial anger, I moved more to action," she says, still fighting back tears. "I know myself, and I know I do better if I'm helping other people."
'WELL, THAT'S NOT A GOOD ANSWER'
Everything came to a head, suddenly, this past April.
Just over a year and a half into her diagnosis, she was starting to feel a strong need to connect to others living with metastatic breast cancer, so she began exploring where she could get support.
It wasn't easy to find.
"I've asked, 'Why doesn't this exist? Why don't you offer something?'" Coffman says, "and the response I got initially was (basically), 'Well, you guys die, so support groups don't last long.' I'm like, 'Well, that's not a good answer.' The other answer I got was, 'If we do one for the breast cancer community, then really we should offer one for all cancers. We just don't have the resources for that.'"
In fact, according to METAvivor, a national nonprofit organization that supports men and women with Stage IV metastatic breast cancer, only about 2% to 5% of the funds raised for breast cancer research is spent on studies of metastasis.
She was angry again. But also mixed in was anxiety, due to the fact that she was just days away from having surgery to remove her ovaries, which also had breast cancer cells in them.
Right around that time is when the email from nursing student David Buckner popped up in her inbox.
IN HONOR OF HIS MOM, AND GRANDMOTHER
Buckner, a first-generation college student, entered UNC Charlotte as a pre-med student.
He also was one of 21 students who were inducted into the Levine Scholars Program, which comes with UNC Charlotte's most prestigious merit-based scholarship -- a four-year award for service-minded students valued at about $105,000 for in-state students like Buckner.
"Then I went to a 25-day hiking trip with my program, and I realized, OK, there's a lot to life, and I do not want to spend eight to 12 more years in school," he says. "Then I found out about nurse practitioning, and I was like, This is like a perfect fit of the things I want to do, as well as a good work-life balance. As best as you can have in medicine."
With that, he switched to the School of Nursing.
As for why he decided to focus on women's health? Buckner and his five siblings -- who grew up in Lowell, a tiny city that sits off I-85 halfway between Belmont and Gastonia -- were raised by a single mother. He considers his grandmother his best friend.
"Those two women have made me as successful as I am today, and I want to give back to the community that has made my life into what it is. Also, I think women are just so great in general -- so strong. They raise our future leaders, so why not promote their health, so they can continue to do so?"
And when he started thinking about a project that would tie in with the civic engagement component of the Levine Scholars Program, Buckner had in mind that it could be something related either to women's health or vulnerable, under-served populations.
Someone mentioned Maren Coffman as a professor who could be a valuable resource for him when it came to developing a research plan.
So on April 13, off his email went.
'I HAD THIS SPARK...'
Coffman did not respond immediately -- in large part because of what she was dealing with at the time emotionally.
"I feel some responsibility," she says, "to make sure that a student has a positive research and community-engagement project experience. I've worked with Levine Scholars in the past. Many. And I wasn't sure at that point if I had the energy to engage in a new project, or develop a new project. ...
"My initial reaction was I can't mentor another student right now."
But after sitting on it for a couple of days and letting it all marinate, she saw an opportunity.
"I thought, If I can't find a community-based metastatic breast cancer support group here, and I'm seeing that across the country -- that, unless they live in a really large city with a really large cancer center, almost no one has access to metastatic-only support groups in their immediate community -- well, let me set up a call (with him)."
"I had this spark," Coffman says, "where it was, OK, if I have somebody that can help me build something meaningful that could last -- that could continue on beyond us, somewhere, somehow -- that would be a meaningful project, both for a student and for me."
Two days later, she typed out a cheerful reply. Soon after that, they met on Zoom.
That's when Coffman told Buckner about her cancer, and of the vision she had for a research project that could help improve the health of a population that was both under-served and largely comprised of women.
By the time their meeting was winding down, he was silently praying that she would ask him to be involved.
MOVING TOWARD THEIR GOAL
Since then, even though Buckner has been absorbed in an internship, his Certified Nursing Assistant courses, and working on campus as a tour guide -- and even though Coffman has been busy being a mom and a professor -- they've stayed in regular communication about the project. And they've made some meaningful progress.
Due to the HIPAA privacy rule, they can't just go to the hospital systems and say, "Give me a list of women with metastatic breast cancer." But they've joined a Facebook group for individuals with metastatic breast cancer that has grown to 54 women.
Fourteen, Coffman says, gathered Wednesday night in uptown, where several skyscrapers were lit up in green, teal and pink in observance of National Metastatic Breast Cancer Awareness Day.
Meanwhile, Buckner has started working on a grant proposal for the community-based, patient-led program he wants to create, which will be shaped by a survey of individuals living with terminal breast cancer and supported and promoted by Carolina Breast Friends. Coffman says the Charlotte-based nonprofit has told her this will be its first foray into providing services specifically to individuals who have been diagnosed with metastatic breast cancer.
If the proposal is approved by the Levine Scholars Program, Buckner will be awarded an $8,000 civic engagement grant.
(They seem, incidentally, to have hit on a hot-button issue: In July, a qualitative study published in the medical journal Medicina drew a conclusion that backs the hypothesis Coffman was working with: "Women with MBC (metastatic breast cancer) have unique unmet information, financial and support needs that have been long overlooked due to increased attention on detection and treatment of early breast cancer.")
But along with the meaningful progress they've made, they've also established a meaningful relationship.
'I WANT HER TO KNOW THAT PEOPLE CARE'
When the two met on campus with the Observer, they greeted each other with a hug, and Buckner says "we hug every time we see each other now."
And despite the air of sadness that occasionally wafts over the pair as they chat about their lives and their work for more than an hour and a half inside the Rowe Building on UNC Charlotte's campus earlier this week, there's more laughter than tears -- and you feel rather hopeful as you listen to them talk.
It might not be a feeling that she'll find a way to live long enough to see all the things she wants to see and do in life, but something about watching them interact just makes you feel good.
"I know that it can feel very lonely to be in her position," Buckner says, turning to look at Coffman. "So I want her to know that people do truly care, and I truly care, and that me doing this project is not only a way to signify that, but to show her how much I care about her well-being and her happiness. ...
"Also, if this is something that could be implemented during her lifetime, I know that could mean the world to her. Of course, I cannot say when -- and she cannot say when -- she will go, but my dream is to have this done before then. I'm hoping she sees this project last for 20 years."
"I would love that," Coffman says softly, smiling at him.
"I hope," he continues, "that she has that true feeling of 'This is my legacy, and I made a true difference for this population.' That is what I hope to gain and to give to Dr. Coffman through this project."
Asked what it's like to hear Buckner say that, she says: "Pretty heartwarming. ... I mean, I'm kind of one of those behind-the-scenes, low-key, keep-my-head-down-work-hard kind of faculty, so it's not like I need something named after me to have it be my legacy. I'm satisfied with adding it to what I write about my life history for my children and my children's children.
"But to know that I've made a difference in the lives of others who need this, that means everything to me."
Buckner smiles at her. Then: "She has not only been academically a role model, but personally she is so strong. I mean, I cannot imagine raising teenage kids, being a mother, being a full-time faculty member, doing research, and having this diagnosis. I couldn't imagine doing any of that without the diagnosis, so adding that on top of it ... it's just really empowering.
"It shows me, OK, life will throw you curve balls," Buckner says, "but you can't give up."
If you or someone you know is living with metastatic breast cancer, and would like to hear more about the work Coffman and Buckner are doing, email Maren Coffman at M.Coffman@uncc.edu.