I'm giving blood products to one of my favorite patients. I know I shouldn't be picking favorites, but I can't help it. There are people you have the pleasure of taking care of and even if it means you have a busier night, it's worth it because you want to take care of them.
I'll call her Melanie. Melanie's oxygen level keeps dropping on me and it's the saddest thing because Melanie had great lungs. She has lungs built for hiking, cross-country skiing, and the dozens of mini triathlons she's run over the course of her lifetime. Her husband tells me she was part of the Four Thousand Footer Club - a group of people who climbed the less known mountains of four thousand feet or greater - because she loved hiking so much. She's also part of the reason I decided to take swimming lessons. Before she was diagnosed with aplastic anemia, she lived the fittest lifestyle. She's the type of patient that reminds me of how fortunate I am to be able to wake up every morning, roll over on my stomach, walk to the bathroom, get myself dressed, and maybe get my lazy ass ready for a run. She's one of the patients that reiterates the importance of not taking your legs, lungs, strength, and energy for granted. Because one day you might not be able to do those things anymore.
Melanie came in for chemo/immune/radiation therapy for her anemia. She was doing well and was getting ready to go home. The treatment itself was hard - that's one of the reasons I feel like cancer is one of the saddest diseases out there (it's takes third place after Lesch-Neyhan disease, and then muscular dystrophy for me). Not only is the disease itself hard on the body, but the treatment is, too. The side effects can be awful, namely graft-versus-host-disease (GVHD), terrible mouth sores, intractable nausea, hair loss, and neutropenia that can turn into a medical emergency if you develop a fever. These patients are vulnerable mentally, physically, and emotionally. Melanie had powered through her immunotherapy before she started developing these crazy complications. First it was Afib with RVR in an otherwise sinus heart (a condition where the atrium of your heart fibrillate or wiggle instead of contracting and getting blood out to the rest of your body properly), then an oxygen requirement from fluid overload and pleural effusions requiring a tap, acute kidney injury that required dialysis, and now, the worst of them all, suspected neuromyelitis optica (NMO), an autoimmune disease that can paralyze the limbs and turn a person blind. Now, take a once strong, independent, healthy, active, and happy human being and strip the strength, independence, health, and activity away from her. What do you get?
Anything but happiness.
Melanie was a champ before the last on her laundry list, NMO, hit. The oxygen requirement alone was enough, in my eyes, to put a conditioned athlete in distress. How would you feel if one day you could hike Mount Monadnock, and a week later realize you couldn't even stand to put some pictures up on a wall? I was getting ready to take care of someone teary eyed and hopeless, but to my surprise, Melanie champed through her breathing problems and faced me with a smile. I was surprised she wasn't depressed. Then came the dialysis . . no one wants to hear they have to go on dialysis. And so, again, I went into work expecting to take care of someone who was just fed up with disease and what it had done to her. But no, she was chipper, happy, and optimistic - again making me feel terrible about myself for not only not knowing how to swim, but not being able to be nearly as happy even without a disease like cancer (seriously - how do these patients do it? I throw a BF when my stomach hurts and here they are battling cancer, able to crack jokes and ask me how my day is). This had to be the end of the line. How was it that she was actually worse off than when she came in - were we making her better, or worse? As if anything else could go wrong. Then it hit again. This time with leg paralysis that started off with unsteady gait, then weakness with a bedside commode, and now total dependence and bedrest. Oh, and she can't see either. Blind and immobile. Probably the best way you could completely demoralize a person and strip the dignity from his or her life.
So now she can't breathe like she used to, walk, see, or even use the restroom like she used to. Her optimism carried her far, but tonight, for the first time since she's been here, I've seen her falter. And it's the most heartbreaking thing, seeing good people suffer. People who genuinely deserve the best, who see life through the best lens, who go into its hardest experiences with the most gusto but lose. It sucks. It's the most deserving people who break, and sometimes I think to myself that it would almost be easier if it was someone I didn't favor because it'd be a little easier to watch her go through this hospitalization. Everyone on our floor hates seeing her the way she is. And don't even get me started on the husband, it'll make you cry (unless you're a man).
Watching your patients lose hope is one of the hardest encounters as a nurse. You don't know what to say sometimes and sometimes the best thing to say is nothing at all. I don't think she will understand the magnitude of how much I respect her outright tenacity, but part of me likes to think she feels it when I ask her what's on her mind, and when I tell her she's inspiring and if that if anyone had the strength to go through this, it's her.
I know these words won't bring her legs or vision back, but it has made me reflect a lot on how lucky I am to be able to be completely handicap-free (aside from being vertically challenged). I think most of us take these simple, unconscious actions for granted. What if you had an itch on your ankle and couldn't even bring your leg up to scratch it? I'm usually pretty good about leaving work at work and taking a deep breath once I leave the hospital doors, but I have been finding myself thinking about Melanie more often. So that's why, next year, I'm hoping to run the Boston Marathon. Because if a man with muscular dystrophy can practically limp across the finish line, and Melanie did a trillion triathlons in her life, then I can sure as hell run it once. It's people like Melanie that make me want to put my legs, body, and entire being into full, good use while I still can.
So be thankful of the body you were given and the fact that you are able. Even if you're fat and unhappy or whatever or don't have that six pack you've always wanted . . at least you know you still have the capability to get it if you tried.