I used to work as a nurse in a medical-surgical floor a few years ago during the night shift. I met a patient that changed the way I look at and treat patients. This patient was in her 50s, and she was just diagnosed with metastasized lung cancer that was likely terminal. She had just found out that same day, and she was flooded with a million emotions. I worked the night shift and came into the room to hand out that evening’s medications. Now that her family members left for the night and she was alone, she finally broke down in front of me and began to say everything that was on her mind.
To be honest, it was difficult to be with her emotionally. Patients in the hospital all share these horrible life outcomes, and that was a true shock upon my first patient contacts. I learned about seemingly healthy individuals succumbing to rare diseases and having strokes and heart attacks at an unlikely age, many dying but many permanently disabled, a shell of who they used to be, prolonging the suffering of their family members. Medical workers in order to last in this profession, somehow need to be OK with completely immersing yourself in these situations every single day and feel like a normal, happy functioning person on the inside. The only way to do this is emotionally distancing yourself from my patients and care for them through being the best professional you can be.
However, this woman was different, and I will likely never forget her. She broke through all my defenses, and I found myself stopping everything I was doing in order to be in that moment with this woman. She reminded me of my mother; they were almost the same age. It could have been her just as likely. She told me about her children and how she didn’t know how they would be psychologically OK with having their mother gone at such a young age. She talked about dying and how she was not afraid, that she wasn’t going to give up, and that she was going to continue fighting every day until the end. She would often laugh during her conversation, perhaps as a defense mechanism when she realized the despair was too great, and so the mind convinced her to do the opposite. Then after she was happy for a while during her conversation, she would describe the good times she has had in her life. She would suddenly be reminded of her likely fate and cry again, often times getting upset. This happy, sad, angry cycle continued for about 30 minutes. I felt frozen. What could I possibly say to this woman that will help her at all? Is everything going to be OK? It is not.
No amount of training, biology or knowing the mechanism of heme metabolism could have prepared me to deal with this patient reaching out to me just inches away. Her sadness and complete despair radiated towards me like a heat wave on hot summer day, and I felt the deepest emptiness, with the physical feeling of a golf ball stuck in my stomach, unable pass through. Then, she stopped talking, and looked at me, her eyes glassy and red. I suddenly became lucid and aware of everything that was going on around me. I looked around, and it was as if the room was gray, I could have sworn it had no colors. I heard my own breath deep in my ears. It was very shallow, yet low in pitch. I felt the weight of my own hands as gravity pulled down on it and my shoulders carried the weight. I heard the roughness of her breathing from her inflamed lungs and bronchus. I felt complete stillness. I couldn’t feel my heart, was it beating? It was as if the world has suddenly stopped spinning and someone hit the pause button, the universe perfectly still. Nothing else mattered at that point. It was her and me in that room, connected by an invisible yet powerful bond between her mind and my own. The human connection. I knew then that I didn’t need to say anything.
Ramses Perez is a medical student who blogs at RamsesMD.
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