Sometimes in my job..no, actually, it happens every day I'm there. Anway, sometimes you see that life is so much harder than you could have imagined.
. Today I saw a man dying of liver cancer, who lived in another state and came to Seattle for a second (maybe third or fourth?) opinion. He was cachectic, which means he was experiencing the extreme weakness, fatigue and muscle wasting that comes with advanced and incurable cancer, but he had a distended abdomen full of third-spacing fluid. He stooped and scooted, slowly, to the ED stretcher. His heart rate was in the 130s, and he was tachypneic (breathing fast) from the effort of a 2 foot transfer from wheelchair to stretcher. Yet he did it. And when I misspoke his name, he corrected me and made a joke about it. Here was this man, who looks barely human, and he still had his humanity. But what he didn't have, and what is so painful to see in the ED that I work in, which is part of a hospital famous for transplants and cancer treatment, is that he hadn't accepted that he was dying. And it was so painfully obvious to us, his caregivers, because we see it every day. In each doctor or nurse's eye who saw him, you could see the truth. But he couldn't. And I wonder: if I am diagnosed with cancer with a low survival rate, like liver cancer stage IV skin cancer, or any of the numerous kinds of cancer that until I started working here I truly hadn't even HEARD of, will I be able to look down the road and see death, and welcome him gracefully, or will I fight and fight, until I have expended every ounce of my strength, of my family's strength, and of my healthcare options, before I yield? When I saw this man, I hoped that I could yield, but I also recognized his fight, his humanity, and mourned that the care we give him will lengthen his life, but won't increase his number of "good" days. But that decision, to fight or yield, isn't up to me, and it is up to him and his God, if he believes. But when I saw the pain in his aunt's eyes, I wondered what is the better part of valor. She quit her job in the other state to come care for him in his last chance at a "second opinion," and you could see that she knew, even if he didn't. She had to leave the room a few times, but she was there for ten hours, a watchful, loving sentinel and witness to his pain and suffering.
I've been that sentinel, in some form, for my grandfather, and I know what it can take out of a person to be that. My grandpa had had a full life, and I do believe that he chose to leave our world when he saw that the pain of his family watching and caring for him was greater than the last bits of life he was living. I will always be grateful for that.
But my grandpa was an old man, and could yield after a long life. This was a young man in his forties. Not only is he fighting cancer, but he is fighting the unfairness of a diagnosis that happened in the prime of his life, when his entire being is screaming to LIVE and grow and feel and love and not to die. He's fighting life itself, as his own body turns against him, and I can't imagine the struggle.
So I watch, and I medicate for pain, and I offer what small consolation I can in the form of responding to his soul, and not the body wasting away from the inside. And I am grateful that I get to do this, and that I work with people who feel the same, and do the same, and still can laugh and lean on each other and go into the room of the next person who comes into our ED, and provide that care. There is no greater honor, and I am so grateful to be a part of it.
. Today I saw a man dying of liver cancer, who lived in another state and came to Seattle for a second (maybe third or fourth?) opinion. He was cachectic, which means he was experiencing the extreme weakness, fatigue and muscle wasting that comes with advanced and incurable cancer, but he had a distended abdomen full of third-spacing fluid. He stooped and scooted, slowly, to the ED stretcher. His heart rate was in the 130s, and he was tachypneic (breathing fast) from the effort of a 2 foot transfer from wheelchair to stretcher. Yet he did it. And when I misspoke his name, he corrected me and made a joke about it. Here was this man, who looks barely human, and he still had his humanity. But what he didn't have, and what is so painful to see in the ED that I work in, which is part of a hospital famous for transplants and cancer treatment, is that he hadn't accepted that he was dying. And it was so painfully obvious to us, his caregivers, because we see it every day. In each doctor or nurse's eye who saw him, you could see the truth. But he couldn't. And I wonder: if I am diagnosed with cancer with a low survival rate, like liver cancer stage IV skin cancer, or any of the numerous kinds of cancer that until I started working here I truly hadn't even HEARD of, will I be able to look down the road and see death, and welcome him gracefully, or will I fight and fight, until I have expended every ounce of my strength, of my family's strength, and of my healthcare options, before I yield? When I saw this man, I hoped that I could yield, but I also recognized his fight, his humanity, and mourned that the care we give him will lengthen his life, but won't increase his number of "good" days. But that decision, to fight or yield, isn't up to me, and it is up to him and his God, if he believes. But when I saw the pain in his aunt's eyes, I wondered what is the better part of valor. She quit her job in the other state to come care for him in his last chance at a "second opinion," and you could see that she knew, even if he didn't. She had to leave the room a few times, but she was there for ten hours, a watchful, loving sentinel and witness to his pain and suffering.
I've been that sentinel, in some form, for my grandfather, and I know what it can take out of a person to be that. My grandpa had had a full life, and I do believe that he chose to leave our world when he saw that the pain of his family watching and caring for him was greater than the last bits of life he was living. I will always be grateful for that.
But my grandpa was an old man, and could yield after a long life. This was a young man in his forties. Not only is he fighting cancer, but he is fighting the unfairness of a diagnosis that happened in the prime of his life, when his entire being is screaming to LIVE and grow and feel and love and not to die. He's fighting life itself, as his own body turns against him, and I can't imagine the struggle.
So I watch, and I medicate for pain, and I offer what small consolation I can in the form of responding to his soul, and not the body wasting away from the inside. And I am grateful that I get to do this, and that I work with people who feel the same, and do the same, and still can laugh and lean on each other and go into the room of the next person who comes into our ED, and provide that care. There is no greater honor, and I am so grateful to be a part of it.
