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.