my work

Here I go, breaking my rules again… (the one about not writing about work)

Its been a hard few weeks at the office.  Even though I feel I’m divinely suited for this job (nurse practitioner in oncology), sometimes its overwhelming, and I think maybe life working in urgent care or a weight loss clinic wouldn’t be so bad.  This last month has been full of disease progression, hospice discharges, and death.  People I have grown to love, struggling with pain, dying too young.

My years of working in bone marrow transplant taught me a certain brand of detachment–  how to stay rooted in the present and not be attached to a future for the human beings in front of me.  It was a powerful lesson in letting go; I couldn’t look into the eyes of children with high risk leukemia day after day and worry about what was awaiting them next month or next year– it was unlikely to be a healthy, normal childhood. I had to care for and advocate for my patients, do the very best job possible every day, but turn over the outcomes and what would happen tomorrow to the universe, God, Buddha, Mother Mary, physicians, someone or something else other than myself. Because there are patients that will die despite a favorable prognosis and everyone doing the right thing, and there are patients that will somehow fight their way out of the grip of death and against all odds, survive. You never quite know in this business.

My patients these days are healthier and many of them are cured.  Even the women with aggressive, metastatic disease usually live years rather than months. I see them week after week, month after month, and I grow very fond of them.  We laugh together, we hug, we share photos and stories, I meet their best friends and relatives.  Its hard to say goodbye after such a long relationship.  I thought I was getting better at this but now I’m not so sure.  My loss of my mother has made me more sensitive to what the families are going through. As I work through my own grief I can feel what the surviving loved ones are experiencing.  It hurts.  I also see my mother in some of these patients and feel as helpless as I did to fix things during her illness.  I sit in the exam rooms with my dying patients and look down at my empty, searching hands.

And yet perspective is everything.  I am greeted with success stories every day.  These women plunged down the rabbit hole of cancer treatment and emerged on the other side, bathed in sunlight. As elusive as those rogue cells can be, resorting to every dirty trick in the book, sometimes cancer is completely slaughtered with the arsenal of treatment.  It happens.  An everyday miracle.  A billion cells, a million microscopic explosions in the battlefield of the body.  Victory down to the smallest unit of life.

Even when the war cannot be won, the enemy is usually held at bay for a while.  Mom’s cancer was very drug resistant, but I still think chemo bought her time.  Important time.  If she were here, I think she’d say that the nausea and the hair loss and the fatigue was worth it for her.

So, what I do weighs on me sometimes.  But it matters.  I can’t forget that.

12 thoughts on “my work

  1. jelebelle

    and we all appreciate every second that you give to us. i think often about my amazing nurses and how i want to cook them all dinner and bring them into my life. impossible to win this battle without you!! thank you for this post; it reminds me that i need to write one about my nurses soon. thank you 🙂

  2. Brenda gillen

    You are one of my heros. I wouldn’t have survived without the excellent care I received. Thank you.

  3. Green Thumb Mama

    I think you’d have to be completely un-human NOT to feel something. It’s hard to look upon suffering and not feel profoundly moved and saddened.

  4. sarenaperez

    When I was diagnosed last December with cancer, it was a young female oncology surgeon who broke the news to me. She had done my initial cystectomy and found the cancer. I started crying and asking her what I did lifestyle wise to bring this on. My mother just turned away and silently cried. I always wondered how doctors, nurses and other health care providers cope with that heavy load. I wondered what she did the day she had to tell a 32 year old woman she had a 50/50 chance of living 5 years. How she felt. What she did to shake off that burden at the end of her work day.

    Over the last 6 months I’ve been seeing an oncology nurse for wound care and today she told me how much I inspired her. How she often wondered how i was doing and she hoped for the best for me. It touched me. Thanks for writing this post. It helps me to see the other side of the coin.

    1. bornbyariver Post author

      I’d be honored if you’d do so. Congrats on getting through surgery! Even if the post-op hospital environment left something to be desired 🙂

      1. bornbyariver Post author

        hm, did you do it in a post? I think I missed it! Not that I need to read my own post, yet I won’t be ashamed to admit it, I’m tickeled you passed it on and would love to check it out for myself!

  5. Stephanie

    I hope you know how important every part of your work is to the patients–even what may seem like the littlest things, like talking to family members as if they exist in the room and are important, offering them a drink or a blanket along with the patient and understanding that cancer and its treatment is afflicting whomever is in that room or ward or “pod.” I’ll never forget out wonderful oncology nurse Heather. She is the one who alone spent more time with us than any health care professional in an eight-month odyssey through three hospitals.

    1. bornbyariver Post author

      Thanks for your words. My patients are grateful, wonderful people. But its easy in nursing to overlook how we do help and focus instead on what we cannot change or alleviate. And patients often dont have the ability to say “thanks.”

  6. Stephanie

    It is so profound–and in a way universal–for you to put it that way: that good people focus on what they can’t change instead of what they can do. I think that’s what I and our family and friends couldn’t get away from (and still can’t): what we couldn’t do. A large part of my mission in writing and doing rounds at hospitals now is to make sure that the nurses and other health care professionals know what they did do that is so helpful to us.

    Even the very fact of our oncology nurse’s pregnancy and the way she was willing to talk to patients who asked her about it (some a tad intrusively, I thought, but I’m a New Englander) was a beacon of hope to all the families around her. When she had the baby I brought her a quilt for the baby and her big sister, and the oncologist said with a smile, “We’ll add that to the pile. We have a room full of presents for when she comes back.”


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