It is Spring today, March 21, 2000. It's been five months of chemotherapy, septic shock, diarrhea, liver
lesions, kidney failure, hearing loss, intensive care, neutropenia and finally renewal. I write this as I await
the final chapter: the rising neutrophil count that will signal a functioning bone marrow and cure from
acute promyelocytic leukemia. It's been a hard road to travel. It's the quality of the nursing care that made it
bearable.
The nurses take our vitals, change our dressings, give us injections, and hang our antibiotics and
chemotherapy. They fetch us food, microwave boluses for makeshift hot water bottles, massage our limbs,
bathe us when we're weak and assuage our distress.
But this floor, 7 Medical, is unlike any other in the hospital. This is not palliative care where all are
resigned to the patient passing on, nor transplant where hope springs eternal, nor surgery where repair
seems guaranteed, nor birthing where joy reigns supreme. This is a floor like no other, we are patients
unlike any other, to choose to be a nurse here is a choice unlike all others.
We are the needy, frightened, confronting life-threatening illnesses. We emote spontaneously; we weep and
wail, act out and expect our nurses to read our minds. We are often irrational, demanding and downright
paranoid in the days and nights when the demons come out. We regress and strike out at those in front of
us, and who is most often there if not our nurses. If we are not important to those who tend to us, who
then?
Here we live and die, we fight like hell for our lives and part of our fight is drawing the nurses close to us
because without that intimacy we couldn't make it. Some die and when we die, they grieve: for those of us
who do die it's all we have: the knowledge that we were important to another human being. And this is the
burden of nursing on this floor: being constantly aware that each life is a fragile one and a finite one, to
know that modern medicine to which they are dedicated can work, but not for all, that miracles can
happen but crisis can erupt without warning and death strike. Our nurses carry within them all the faces
of their patients and I wonder how they deal with this constant attachment and loss: and it is loss whether
the patient is cured and walks away or dies under treatment. How do they live normal lives at home? What
strength do they have to bring children into this world? How do they provide care without being sucked
into our anxiety? One either embraces life fully or goes mad it seems to me. Anyone who can't, finds no
place in oncology.
The eyes they look into are fearful, searching for solace, often dumbstruck with terror. Alone in our beds,
lonely in our souls we depend on the nurses for emotional succour, for understanding, if only to assuage
our guilt for the tiff with our spouse, or wash away the quick word we just had with a visiting child. As
each ache, pain, burning sensation arises we cry out, moan, bitch question our nurses frantically whether
this means impending crisis or merely par for the course. At moments like this a wayward word devastates
us; the appropriate one gives us courage to go on.
At nights and on weekends, they are our lifelines. We hope and pray they have the right answers because
the doctors are few and far between. Now our dependence is flagrant, our demands insistent.
When the room next door is being emptied we know what we don't want to know, that one of us has gone
and no host of angels or medical engineers will ever bring them back. And we tremble and weep deep
inside.
How do we navigate in this crazy oncological world where "acute promyelocytic leukemia is the best one to
get", where "diarrhea is proof positive that chemotherapy is working"? How do they? How do our nurses
retain their balance, neither drown in our sorrow nor turn cold to our plight, nor sacrifice their families to
their profession?
Blessed are the nurses who make us whole again, day and night; the nurses who come with a smile and a
laugh, the nurses who read the fears behind our brave fronts, the nurses who held our hands through the
bone marrow biopsies.
Blessed are the nurses who ran downstairs to get our platelets and blood or across the hospital grounds to
deliver a culture, the nurses who answer our calls even if they weren't assigned, those who took time with
an injection and place the thermometer gently in our mouths.
Blessed are the nurses who credit us with intelligence, who call their colleagues to attention, and those who
tell us the gritty truth when we need it.
Blessed are the nurses who drop in just to say hello, who turned a blind eye as I snuck a fridge into my
room, who danced salsa and meringue with me in the wee hours of the night, and the nurses who asked the
same repetitive questions at every watch, for it made me feel secure.
Blessed are those who allay our fears, give us hope and nurse us through this nightmare.
This letter is dedicated to oncology nurses everywhere.
Permission to use or copy as long as you cite the site. If you have comments or suggestions, email me at avramavl@hotmail.com
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