PDF of Total Patient 1212

There are many ways to help a patient who is struggling through cancer. Of course, most of them are medically advanced; but some of them—well, not so much. One of the newer low-tech techniques uses a concept so simple that one can apply that timeworn description: “It’s so easy even a child can do it.” 

Joan’s Monarch Wishes is a volunteer organization that was started by Lori Smith Genzel and her sister, Jen Schnaars, after their mother, Joan A. Smith, lost her battle with lung cancer in August 2010. The program involves an easy effort: volunteers send greeting cards, written notes, and bookmarks to hospitalized patients undergoing treatment for cancer. A card might be a store-bought card that is personalized with a note written by a volunteer, or it could be completely handmade by an adult or, often, by a child.

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At this time the organization has approximately 225 volunteers, called ambassadors. The organization asks hospitals, family, and friends for the names and addresses of patients with cancer who would like to receive a card. The list of names is sent to the ambassadors. These volunteers, who pay for all materials and postage themselves, create or buy a card and send it to a patient on the list. Many ambassadors send cards to all the patients on each list they receive, so a patient may be the recipient of many cards each month. It becomes exponential.

In addition to the individual cards the ambassadors buy or create, card drives are held, which is a group effort to personalize or create and deliver a large number of cards to one medical center. One card drive commemorated the 1-year anniversary of Joan Smith’s death by delivering more than 1,400 cards to patients at one facility. Boy and Girl Scouts, church groups, senior centers, scrapbooking clubs, YMCA after-school groups, and medical staff have contributed their handiwork to Joan’s Monarch Wishes.


The name of the organization is significant. When Smith was near death, Genzel asked her mother to send her a sign that she was okay after she died. Smith said she would come back as a butterfly. She loved butterflies, and the plants in her yard had always been a favorite destination for the beautiful insects. On the day of her funeral, one large Monarch butterfly flew around and sat on top of the flowers on her casket. 

Comforted by the presence of the butterfly, Genzel researched the Monarch butterfly and learned that it must survive four difficult life stages as it matures from a caterpillar to adulthood. Genzel thought that was an appropriately parallel journey for an organization supporting people living through cancer. So the group’s founders formally selected the Monarch butterfly as its symbol because “…it reminds us of new life and the journey that must take place in order to get to bigger and better things. Just like the butterfly, the journey of a person living with cancer is the same—you have to get through the challenging times in order to get to the good.”

The organization also pays tribute to oncology nurses. When their mother was so ill, Genzel and her family were impressed by the “tremendous love, tenderness, and comfort” provided by the oncology nursing staff. They wanted to acknowledge some of that love and comfort, and hope that the cards and notes send similar feelings to each patient.

Genzel also noted that some of the volunteers become pen pals of the patients they send cards to, and many of them receive thank-you notes. She
 was delighted when one of her patient recipients actually sent her a card and the gift of a beautiful butterfly-themed bracelet. 


Many of the program’s volunteers find that the time they spend making the cards and other items with their children is a special kind of quality time. They talk about different ways to send love and encouragement to those who are ill, and how personalized cards and little gifts with encouraging sentiments can be so helpful. Smith’s grandchildren really appreciate this time, because it is an opportunity for the family to talk about a grandmother they barely knew.

Genzel and her family hope that Joan’s Monarch Wishes continues to grow and comfort patients battling cancer throughout the country. Her goal is for the group to become a nonprofit corporation, and create a Joan’s Monarch Wishes line of caring cards to sell at retail card and gift stores nationwide and online, ready for anyone to personalize and send as a means of giving a needed lift to a patient’s spirits. In the meantime, a growing number of patient requests are keeping the Joan’s Monarch Wishes ambassadors quite busy.

To nominate a recipient or to become a volunteer, write to joansmonarch
[email protected] ONA

Bette Weinstein Kaplan is a medical writer based in Tenafly, New Jersey.


• In Focus with Steve Highsmith [Joan’s Monarch Wishes appears in the “Kisses for Kyle” segment.] ph17.com. http://www.myph17.com/shows/in-focus/. Accessed November 18, 2012.

• 1,000 Cards of Hope. The Photo News. http://www.thephoto-news.com/apps/pbcs.dll/article?AID=2012120719983. Accessed November 18, 2012.

• Greeting-card effort brings joy to cancer survivors. Record online. http://www.recordonline.com/apps/pbcs.dll/article?AID=%2F20120823%2FCOMM%2F08230307. Accessed November 18, 2012.

• Kaufman M. Mom’s struggle to survive inspires card drive for patients. The ONC. http://www.theonc.org/author.asp?section_id=1805&doc_id=250341. Accessed November 18, 2012.