Montana Christiansen stepped forward to ring the bell that signaled the end of a journey. She was surrounded by her family and a team of Mayo Clinic caregivers.
There was just one person missing: her mom, Amie Christiansen. Montana would be ringing the bell in Amie's honor. And in her memory.
"A couple of months before she passed, my mom said how nice it would have been to ring the bell like she'd seen so many other people do after finishing cancer treatment," Montana says. "It was one thing she had wanted to do before she passed away."
After Montana shared that wish with Amie's care team, they found a way to make it come true.
In 2012, Amie was diagnosed with indolent, nonaggressive non-Hodgkin's lymphoma. The disease progressed slowly but surely, eating away tiny bites of her future.
Amie faced the disease head on, doing everything her doctor, Patrick Johnston, M.D., Ph.D., asked of her. First, there was a bone marrow transplant that bought her six disease-free months. Then came a series of therapies and clinical trials that would extend her life but not cure her disease.
"Amie told me she never worried about her disease because she knew I was always thinking of what's next," says Dr. Johnston, who saw Amie nearly every month for a decade.
"Amie was an incredibly kind and thoughtful person. ... She truly cared about other people."Patrick Johnston, M.D., Ph.D.
The most recent "what's next" was a new line of therapy that Amie seemed to be responding well to. So well that her death on New Year's Day surprised both her family and her care team. She was just 47 years old.
Shortly after her mother passed away, Montana reached out to Cecilia Merrigan, a nurse practitioner who had cared for Amie.
"Montana was working to cope and process her loss," Merrigan says. "She mentioned during that call that her mom had always wanted to ring the bell."
While bell ringing is a common tradition for patients finishing radiation treatment, it isn't as well established in chemotherapy areas. So, the Hematology floor where Amie received treatment didn't have a bell for patients to ring.
At least not yet.
"I told Dr. Johnston and our social worker what Montana wanted to do," Merrigan says. "We decided to make it happen."
The team ordered a brass nautical bell, set a date for the bell ringing, and posted flyers inviting staff who'd known Amie to attend the ceremony.
"There must have been 20 people there," Montana says. "There were doctors, nurses, front desk staff. It seemed like everyone in the department was there."
The turnout was a testament to the impact Amie had on those around her.
"Amie was an incredibly kind and thoughtful person," Dr. Johnston says. "She knew most of the desk staff by name. She'd always ask how her caregivers were doing. She truly cared about other people."
"She was so sweet and had a genuine interest in other people," Merrigan says. "She had a real connection with all of our staff."
"We don't often get closure when a patient passes away. It was an emotional experience for all of us."Patrick Johnston, M.D., Ph.D.
At the ceremony, Montana, Merrigan and Dr. Johnston each shared memories of Amie and the impact she had on their lives. Merrigan and Dr. Johnston gave Montana, her sister and her father small gifts, as well.
"I don't know what it's like to lose a parent, especially that young," Merrigan says. "I gave them butterfly pocket charms, which I thought would be something tangible they could touch and think of their mom."
Dr. Johnston gave the family each a small bell that he'd purchased when visiting a Buddhist temple in Thailand.
"I told them to think of Amie when they heard the bells ring," Dr. Johnston says.
Montana says the ceremony would have made her mom "feel really special." It made her and her family feel special, too.
"Hearing Dr. Johnston and Cecilia talk about my mom, and to see the response from the whole care team meant a lot to us," she says.
The ceremony was meaningful to Amie's care team as well.
"We don't often get closure when a patient passes away," Dr. Johnston says. "It was an emotional experience for all of us."
While Montana and her family left with small bells to remember Amie by, Dr. Johnston and the rest of Amie's care team have a larger bell to keep her in mind. The brass bell Amie's family rang in her honor will remain in the department and be available for other patients to ring.
"If patients want to feel the excitement or reward of finishing therapy, whether curative or not, they can ring the bell," Dr. Johnston says.
His colleague, Thomas Habermann, M.D., built a wooden stand for the bell. On the back will be a brass plaque engraved with four simple words: In Memory of Amie.
"Amie was so special and always had a positive impact on people," Merrigan says. "It's nice to see that carrying on."