A Bright Light
In oncology nursing I came to love primary nursing. Some would argue I “primed” every patient I met, but sometimes I couldn’t help myself. The first time I cared for you, I signed up for you immediately. I was the first one on your list because I was the nurse who admitted you. This meant whenever you were admitted and I was working, I’d take care of you. How lucky was I!
The day you came into the hospital, you had a tennis ball-sized mass growing on the side of your neck. It looked very uncomfortable. Other than that, you looked great. The sad thing was, cancer attacked you from the inside out, so even if you looked okay from the outside, that was never an indication of what was going on on the inside.
The first day you spent in the hospital we had to put you in a semi-private room. I apologized for this, I hated delivering this news to patients. It’s bad enough when I know someone’s coming in with concern for a new cancer diagnosis, never mind taking away all their privacy by putting them in a semi-private room. Of course, you didn’t mind at all. In fact, you never complain about anything. I remember when the team of doctors came in. They needed to do a couple procedures to provide you with a definitive diagnosis, which would determine your treatment options. By the end of your first day there, you had had a bone marrow biopsy done, as well as a lumbar puncture. Ouch! A bone marrow biopsy essentially consists of a screwdriver-like tool with a hollow center, that pierces the bone marrow of the hip bone to obtain a sample of bone marrow from the center of that bone.
Bone marrow is the factory that produces WBC, or white blood cells, RBCs, or red blood cells, and platelets. When blood cancer is suspected, this is what confirms that. This is often done at the bedside, with local anesthesia. Immediately after finishing the bone marrow biopsy, you had the lumbar puncture done. I felt so bad for you. You had no idea what to expect. How could you? But I had watched these procedures so many times, and I cringed every time I observed a lumbar puncture. Something about a needle entering your spine always freaked me out a bit. During a lumbar puncture, which also often uses a local anesthetic, an uncomfortably-long needle is inserted between two vertebrae (this spot is felt solely by palpation) in order to collect a sample of CSF, or cerebrospinal fluid. I couldn’t believe what a trooper you were through both procedures. Even after a torturous evening, you never once complained. Once these procedures were done, it wasn’t until several days of waiting that your results came back. These results in combination with results of a needle-aspiration biopsy of your neck mass confirmed DLBCL, or Diffuse Large B-Cell Lymphoma.
You received one round of chemo after another. After chemotherapy, you received radiation. After radiation you received an experimental CAR-T cell therapy. During CAR-T cell therapy, your white blood cells are collected and sent to a lab where they are genetically modified, so that when they re-enter your body, they attack your cancer cells. You went through this treatment without any complications, which in the moment may have seemed reassuring. However, as someone who had seen several patients go through this treatment before, it seemed as if the patients who had no complications during their hospital stay for CAR-T cells, ended up returning with a relapse of their cancer. Unfortunately, that’s exactly how your story unfolded.
You were known for your friendly smile, infectious laugh, and optimistic mindset. Family was everything to you, and you took me in as one of your own even though I was a stranger to you. You’d see how hard I was working and acknowledge it. You insisted I sit down and take a break by asking for two orange juices and then offering one to me. Sometimes at dinnertime you would order an extra dinner roll and try to persuade me to have a snack because you knew it was likely I still hadn’t had my lunch. You made me look forward to working, instead of dreading it. I still cherish all the time I squeezed in to circle back to your room for your stories. You stories always revolved around your loved ones, often about all your travels or about you passion for cooking in the kitchen. I remember night shift worked out conveniently for us because once all of my other patients were tucked in, I’d circle back to you. Timing worked out this way because you were always up late while on steroids. Instead of complaining about your insomnia, you saw it as an opportunity for us to share more time together, exchanging more stories. I often thought what a better place this world would be, with more people like you in it. As a nurse, it’s people like you that remind me of my why. As a patient yourself, you were consistently a bright light for us nurses, but also for the patients around you too.
Despite the number of times you had to hear “your cancer’s back”, you remained grateful for the care you received. You never questioned your care team. In fact, you fully entrusted us, and in return we failed you. After failing all your treatments, you transferred your care to DF to start a clinical trial. After that trial failed you too, all treatment options had been exhausted. You were then transitioned to CMO and passed away shortly after. I still hear your laugh. I still feel the comfort your presence brought. I still see your smile that so effortlessly lit up a room. You left such a big mark on the world before you left, which made your passing that much more painful. I’m sorry from the bottom of my heart that you were taken from us so soon.