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THE ONCOLOGIST with the worst bedside manner of any doctor on our staff had just left my patient’s room. “Pancreatic . . .” he’d said. “There’s nothing we can do . . . Hospice.”
I knew it was unlikely that Sandra and her husband, Will, had heard more than that, even though Dr. Richards had said more — too much for any patient hearing a terminal diagnosis to absorb.
I finished hanging the next bag of morphine and increased the dose frequency the doctor had ordered. Sharon and Will looked like they had been flattened by a bulldozer. Nothing left of them. I’d seen it many times before: leaving one’s body was a useful defense mechanism, if only it actually worked.
Sandra had been admitted three days ago for nausea and severe lower back pain. Several scans and blood tests later, this: Stage IV, no treatment options — at least none that would buy precious time.
I stepped to the edge of Sandra’s bed and took her hand. Will remained leaning against the window sill, his gaze fixed on the far wall. Sandra looked up at me like a terrified four-year-old, begging Mommy to make it better.
“Sandra,” I said softly, “I can only imagine the devastation you must be feeling. I’ll stay here with you. Let me just tell the charge nurse where I am, and I’ll be right back.”
I knew that the chances of getting permission from Nurse Ratchet to spend five minutes with Sandra and Will were almost nil. I still had meds to pass to six more patients and labs to draw on two. I must have looked determined, though, because Christy agreed to give me fifteen minutes, as long as I promised to catch up in record time.
All the way through the grueling years of nursing school I had a three-by-five card posted on my refrigerator: “Be a gift of presence.” It was my heart’s desire, a reminder of why I wanted to become a nurse, and it kept me going through the overnight study sessions and clinical rotations. In the year I had been on the oncology floor, however, I’d learned that “presence” was the one thing nurses could rarely offer. The pace was intense, the workload insane. I couldn’t remember a time I’d spent fifteen minutes with a patient, except to do the laborious admission paperwork.
Reentering my patient’s room I pulled a chair to the bedside and again took her hand. The shock was starting to wear off for Sandra and Will, and tears were falling silently. I was on holy ground. Suddenly Will bent over double and yowled, guttural moans erupting from his chest.
“This can’t be happening!” he choked out. “We have plans!” They had told me they’d been married for 37 years, and retirement was just around the corner. Cancer didn’t care about plans.
I stepped around the foot of the bed and gently guided Will to the other bedside chair. Sandra reached for her husband’s hand, and they both sobbed. I couldn’t think of anything to say.
Five minutes passed, 10 minutes, 14. “I’m going to go start your discharge paperwork,” I said softly, and get you some information about hospice services.” Will nodded. Sandra had left her body again.
I am utterly useless! I thought to myself, as I headed to the nurses’ station. I should have said something, anything! But I’d just stood there like an idiot. So much for making the most of my 15 minutes.
Discharge always took hours, so I finished attending to my other patients and bringing pain medication to several. At the end of my shift, I noticed Will sitting in the central family waiting area. He had aged a decade.
He stood up and came toward me, extending his hand. I took it in both of mine. After a few moments of fighting back tears he said, “Thank you for not saying anything earlier. It was such a comfort just to have your presence with us.”
“It was my honor, Will,” I said, a sheen of tears in my eyes.
When I got home and kicked off the shoes I’d been walking in almost non-stop for twelve hours, I sank into a kitchen chair and rubbed the back of my neck. Glancing up, it was as if the three-by-five card was smiling at me from the refrigerator.
“The gift of presence . . . That’s you.”
Weary to the bone, I smiled back. I was looking forward to a hot bath.