(a true story)
Copyright 1999 by Macfadden/Sterling
Every critically ill patient that is admitted to the hospital leaves some type of lasting impression on the lives of the medical personnel they come in contact with. It's true that some, more than others, create an impact on our minds, on our hearts. Such was the case with Robert.
From Robert's words and his medical report, I pieced together what happened before he was transferred to my floor. As the nurse in charge, I was always careful to know all I could about each of my patients. I admit, to save my sanity, I try to not know more than is necessary about their personal life. My biggest concern is their physical problem.
It was a Friday evening and I was in the middle of a sixteen hour shift. Hospitals all over the city were short-staffed and ours was no different. I'd just gotten a patient report phoned in from ER when I heard the rubber wheels on a transport gurney rolling down the hall. Knowing this was my new admit, I stood up to walk into the room across from the nursing station to greet my new patient.
He was a young man with dark hair and soulful brown eyes. The pallor of his skin blended in well with the crisp hospital sheets on his bed. Beside him walked a slim woman with long, flaming red hair. Not even the worry on her face could mar her beauty. They were holding hands in a white-knuckled grip. It was obvious these two were deeply in love, and terrified.
After the orderlies lifted him onto his bed from the gurney, I smiled my appreciation of their help. With a casual two-finger salute, they strolled from the room. I opened the chart they had left with me to scan over the front sheet.
"So, this is Robert? Hello, Dear. My name is Mary and I'll be your nurse tonight. I'll be here until 11 p.m., so we have plenty of time to get to know each other better."
Robert smiled weakly and turned to the redhead still clutching his hand. It was then that I noticed he was wearing a wedding band.
"Robert, is this your wife?"
His smile widened. "No, but we're engaged. This is De Anna, my future wife. We have a wedding date set for five weeks from tomorrow."
"Oh, I'm sorry. I just happened to notice the wedding ring on your finger and I thought…"
Unexpectedly, a large tear rolled down De Anna's lovely face. Robert brought her hand to his lips and kissed her palm.
"It's gonna be okay, Baby."
De Anna began to shake her head in a vigorous denial. Then just as abruptly, her tears stopped, she wiped her eyes and smiled.
"Yes Robert, it is going to be okay."
Robert pulled his gaze from his fiancee long enough to flash a brilliant smile in my direction.
"Isn't she great? Isn't she beautiful? God, I love this woman so much."
I smiled again, then began the admission routine.
"Robert, what brought you to the ER?"
The grin slipped from his face and he turned his full attention to me.
"It's my back. It started hurting a couple of weeks ago. I thought I'd pulled something helping a friend move, but now I'm not so sure. Anyway, when I got up this morning, I could barely walk. The pain was so bad that I broke down and called De Anna to drive me here. It has to be bad for me to do that. I hate doctors and hospitals. Oh sorry-no offense."
I chuckled, "None taken. Do you have any other health problems that may have contributed to this, or any you feel I should know about?"
De Anna's head dropped and Robert stared at the ceiling, as if looking for an answer there. A frown formed between his eyebrows as he took a deep breath.
"Yeah, I have cancer."
I began flipping through the pages of the chart but was so surprised I couldn't seem to focus. Robert looked fairly healthy though he was quite thin. I suppose a terminal illness was the last thing I expected to hear him tell me.
The speaker box on the wall of the room squawked. "Mary, there's a Dr. Henning on the phone for you."
Grateful for the excuse to leave the room to regroup my thoughts, I apologized to both of them.
"I'm sorry. I'll be right back. Doctors get a bit testy when kept waiting. I'll go over your chart before I come back, Robert, so I'll be more familiar with your case."
His even white teeth gleamed, "Sure, take all the time you want. I don't think I'm going anywhere for a while. Besides, I have this gorgeous woman to keep me company."
I laughed, but it sounded forced even to my own ears.
When I finished with the doctor on the phone, I pulled Robert's medical chart toward me. It was easier to pull than lift it, so massive was its size. I began with the cover sheet that gave personal information on the patient.
Robert Wright: S/W/M, age 23
Occupation: computer technician
Chief complaint: severe back pain
Previous medical history: cancer of right hip and pelvic bone
Previous medical treatment: chemotherapy administered in TX
Prognosis: at the patient's request, chemotherapy was discontinued. Pt was told his life expectancy was two years or less
I opened the chart to the back sheets that contained earlier medical records. According to what I read, Robert's chemotherapy had been nearly two years ago.
I turned my head from side to side to loosen the knots caused by a tightening in my neck. I closed my eyes and massaged my temples, which had begun to throb more with each line I read in the young man's chart. Several times my vision blurred as I ran my finger down the long list of tests that had been conducted, and the ones yet to be completed.
I lifted the phone and dialed the number for ER, to speak to a triage nurse. It was as I was again speaking to the nurse that had taken care of Robert that I began to cry.
"Hi Mary. What can I tell you that wasn't in the chart? Only that Robert and his fiancee were told that he has only two options. One is he be admitted for chemotherapy, or two, go home to call Hospice to make him comfortable until he dies. Robert said he'd promised himself he'd never go through chemo again. He was advised that is his only chance. He asked how long he had, that he was getting married in five weeks. The doctor in attendance told him he wouldn't be able to get married then because he would, in all probability, be dead. There was a lot of crying. Robert then asked his fiancee to get out the wedding ring she had bought for him. He told her to put it on his finger. At first she resisted; she said it was for the wedding. After she thought about what the doctor said, she put the ring on his finger. The fiancee begged Robert to do the chemo, to give them a few more weeks. Robert being admitted shows that he intends to do so. This is a sad one, Mary. Right now I'm glad I'm in E.R. and not in your shoes."
I agreed. Right about now I envied her brief association with each patient. I knew that, in all likelihood, I was going to watch this young man die. It's never easy to lose a patient, but this one was going to be especially heart wrenching.
I squared my shoulders and walked back into Robert's room. De Anna was sitting beside him on the bed, both of them deep in what appeared to be a painful discussion. I imagined that any discussion between them at this point was going to be painful.
"Robert, I've been going over your chart and see that you've had chemo before."
A dark looked passed over his face.
"Yeah, I did. I hated it and said I'd die before I'd do it again. Well, it seems it's come down to that, now. It's just that, all of a sudden, I've got a reason to live, so I guess we're gonna do the chemo thing again."
De Anna's look was one of love, and sadness. She spoke for the first time.
"Robert didn't want to do this, but I begged him to. I admit I know nothing about chemo, but I've heard it's pretty bad. I don't want to make him worse; I just want to keep him a little longer. He's got a wedding to go to, and he's not getting out of it that easily."
Her desperate attempt at humor did little to dispel the thick cloud of hopelessness that was almost palpable.
"Let's begin with you telling me, from the beginning, what brought you to the E.R. and go from there."
"The pain I've been having in my back just kept getting worse and worse. When I first got here, they thought it might be a kidney stone. God, right about now I wished they had been right. I guess the urine specimen and x-rays ruled that out. So next we went to a, uh… What was that test called De Anna?"
Softly, almost a whisper, "A C.T scan."
"Yeah, that's it, a scan. I guess it was after the scan they decided the cancer has come back and is spreading to my spine."
Robert held his breath for a second, composing himself. Silent tears coursed down De Anna's cheeks.
"Well, anyway… They wound up telling me it's chemo or death. Which is silly, 'cause it's gonna be death anyway."
De Anna grasped his hand, "But we can have a few more weeks, Robert."
Tears swimmed in his eyes. "I'm not sure of that, Honey, but I'm willing to give it a shot."
I cleared my throat and began to tell them what would happen next.
"Ok, here's the game plan. Evidently, they don't think you can glow in the dark yet so they're going to take more x-rays and another CT scan. We're going to take so much blood you'll swear we're supporting a vampire. It says in your chart that we may be doing an ultrasound, too. You know what that is, Robert?"
"Yeah, yeah, yeah, I know what that is. I'm sorry. I don't mean to sound cranky. I'm just tired and hurting."
"Well, that's one thing I can do something about, Robert. You've got orders for a pain injection every three hours if you want it. It will help the pain and you might even catch a few minutes sleep between tests. Want me to go get it now?"
He looked at De Anna and she nodded.
"Yes, Robert, take the shot. We can talk when you wake up completely, okay?"
I met the x-ray technician in Robert's room when I took the syringe of medication to him.
"Oh no, you don't. You just hold on one minute until I can give him this shot, then you can move him."
Robert had been gone to x-ray for about fifteen minutes when I heard muffled sobs coming from his room. Against my better judgment, I walked across the hall. De Anna was sitting in a chair, bent at the waist, her arms wrapped around a pillow with her face buried. When she saw me come in, she took a deep breath, wiped her eyes and stopped crying.
"I'm sorry. I thought no one would hear me. I don't mean to act so weak. In front of Robert I try so hard to be strong, to not break down. Sometimes I can do it, other times I can't."
Alarms sounding in my head, I sat down beside her and put my arms around her quivering shoulders.
"Want to talk about it? Would that help?"
"I don't know. What good will talking do? It's simple; Robert is going to die and there's nothing I can do about it. I'm hurt, I'm sad, but mostly I'm mad."
"I can understand…"
Her face was twisted into a grimace of anger.
"Do you? Unless you've lost the only man you've ever loved, you can't understand how I feel. Oh, I'm so sorry…"
"No, Honey, it's okay. And you're right; I don't know how you feel. But I've been told I'm a great listener."
De Anna moved from beneath my arms and began to pace the room. The more she walked, the more she talked. I just sat quietly, letting her vent her feelings.
"I've been on the phone, calling everyone I know, asking them to pray for Robert. His name is now on more prayer lists than I even know about, I'm sure. A dear friend of ours, David, came by E.R. and prayed with Robert for a long time. David feels like this can be turned around if only we believe…"
The tone of her monologue turned from one of anguish to that of rage. I didn't blame her.
"This isn't fair! He's so kind, and he tries so hard to be a good person. Why can't it be someone else that's dying? Why not some scum of the earth, like a drunk or drug addict? Why can't God take a man that beats his wife, or mistreats his kids? Why Robert? He's only twenty-three years old! This is so wrong! I hate this!"
At this point she fell across Robert's bed and held her face in his pillow. All the anguish she was feeling soaked the pillow, yet it muffled the screams of anger she was experiencing.
I sat beside her and stroked her long, silky hair. I crooned to her as I would one of my own children, not making promises, just making comforting noises. There was nothing else I could do. I couldn't give Robert a longer life. I couldn't make him live long enough to repeat his wedding vows. I couldn't help him to grow old with the woman he loved.
We both heard Robert's voice at the same moment. He was joking with the transport person as they made their way down the long hall. De Anna jumped up and ran to the bathroom. I heard water running and knew she was trying to wash away any evidence of her tears. But Robert would know, and he would love her more because of it.
When I went in to pick up Robert's dinner tray later that evening, I saw he hadn't touched it. He and De Anna were staring at the flickering images on the wall-mounted TV set as if they were actually watching it. They both smiled at me when I walked in the room.
"Robert, how are you feeling, Dear? Need anything for pain? It's been quite a while now since you've had a shot. It's late and it could help you sleep."
"I'm not really in that much pain, to tell you the truth. Tell you what I would like to have, though. Can you get a blanket for De Anna? She's freezing."
He smiled at her and she grinned.
"Robert, I'm not the one that's in the hospital, Honey. I'm fine. Take your shot and go to sleep."
"Nope, not until you get a blanket and I can see you're dozing off. Then I'll get the shot."
De Anna shook her head in mock consternation.
"Stubborn men! Ok, if that's what it takes, you got a deal."
I handed her a blanket from the closet and she curled up in the chair next to Robert's bed.
"Well, ready for that shot now, Robert?"
"Yeah, I guess so."
As I was administering the injection, Robert talked to me.
"You know, I've never seen so many doctors in one room like they were in E.R. I had seven of them in there with me. Talk about crowded! Oh well, seven's a lucky number, isn't it, Mary?"
"It sure is, Robert. Try to get some sleep now. You're going to have a full day tomorrow."
He groaned, "Yeah, I know."
He then turned on his side, facing De Anna and watched her fall asleep.
I checked on both of them many times throughout the night. Each time, they were both sound asleep.
When I clocked out at 7 a.m., I was weary in body and heart.
It seemed as if I'd only just left when I walked back into Robert's room that afternoon. I noticed that De Anna had either left long enough to change clothes, or someone had brought her something else to wear. Both of them greeted me with their now-familiar smiles.
"Hi there, Mary, Mary, quite contrary."
De Anna giggled. "Oh Robert, that was so corny."
"Yeah well, corny is as corny does."
She groaned. "Oh yeah, that's so much better, Honey."
"How are you feeling this morning, Robert?"
"I'm feeling pretty good. My back still hurts, but nothing like it did when I first came in here."
"Well, that's good. Feel like eating this morning?"
"Yeah, I do. I'm really hungry."
I was carrying his breakfast tray in to him when Robert's physicians blocked my path. I put the tray back on the serving cart then went in to stand by my patient as he was given the bad news.
Just as Robert had said, there were seven of them. The small room had suddenly gotten crowded.
Dr. Fields was evidently going to be the spokesman for the group.
"Good morning, Robert. De Anna, I doubt you slept very well in that chair last night."
The young couple replied in cautious tones of voices. Both of them wore a look of dread on their faces.
"Come on, kids. It's okay to smile, you know. I understand-we haven't given you one single reason to smile. Yesterday we pretty much blew your world apart. Well, I believe you're going to like us much better today."
The look of dread was replaced by one of suspicion. I, myself, felt as if I was holding my breath, afraid to hear the doctor's next words.
Robert's voice was shaky, "Ok, I'll bite. What are you talking about?"
Dr. Fields chuckled, "Not going to allow yourself any false hopes, right? Good, that's a smart thing to do. We want to talk to you about your test results." Some of the other doctors began to nod their heads. I saw Robert swallow hard and De Anna's eyes opened wider. Dr. Fields continued.
"When you first came in here, Robert, it didn't look good. From all indications, it appeared that not only had the cancer come back, but also it had spread to your spine. We suggested chemotherapy to try to combat the assault, but to be truthful, we didn't hold out much hope that it would work. The most we could have hoped for was to buy you a few more days, or being optimistic, a few more weeks."
Robert's eyes were now as large as De Anna's.
"You're speaking in past tense."
Dr. Fields smile covered his entire face.
"Yep, I sure am. Robert, this is going to be hard for you to believe. De Anna, hold onto your seat. The tests we ran yesterday are completely different from the ones we ran when you were in E.R. In fact, they don't even look like they were done on the same person. The difference is astounding."
The young couple took each other's hands, allowing hope a small opening. Dr. Fields stepped closer to the bed, his smile growing more with each sentence.
"Robert, the cancer is gone."
Even I gasped. De Anna stood as if shot from her chair. Robert sat up straighter in the bed. He was so surprised he could barely get his question out.
"Just what does this mean? What exactly are we talking about here?"
"Okay, let me attempt to explain this. Attempt is all I can do, believe me. Test results from yesterday showed no reoccurrence of cancer. Not only has it not spread, we can't find any evidence of a tumor. We are able to see the thinning of the bone around your right hip and pelvic region, which is normal after chemotherapy. From what all of us have seen, the biggest problem you'll have is that these areas will ache more, possibly have more arthritis than the rest of your body, when you get older."
De Anna held up her hand to stop him.
"Wait… What did you just say?"
Dr. Fields seemed to almost glow with happiness, himself.
"That's right, De Anna. I said 'When you get older'. Robert, looks like if you want to get out of this wedding, you're going to have to find another excuse."
Robert, still fearful to accept what he was hearing, wanted to understand.
"But, how did it happen? Did the tests get mixed up? Are you sure you're talking about my body? There's no confusion? I don't get it."
"Neither do we, Robert, but let's discuss this. Now, if you're a pragmatic person, you might think that there was some type of spontaneous remission, and be totally confused by how it all came about. Out of the seven of us, that's the professional opinion of four. Then there are three of us that have a different theory altogether. We three are Christians, and firmly believe the hand of God altered your physical body. I believe, with all my heart Robert, that we're looking at a miracle. So, if you want to be logical, you can rub your chin and say 'Hm'. If you believe in God, get down on your knees and thank Him because he just gave you back your life."
De Anna threw her arms around Robert, joyful tears coursing down her face, and laughed.
"Robert! Oh, Robert! We're going to get married!"
Dr. Fields took one of Robert's hands and shook it.
"Robert, you better marry this girl in a hurry. I believe she loves you."
Both Robert and De Anna were laughing and crying so hard that they didn't notice when the doctors left the room. I closed the door behind me to give them privacy and time to grasp what they'd just been told.
An hour later I handed Robert his discharge orders.
"You're to follow up with your family doctor, Robert. I have a prescription for muscle relaxers and mild pain medication. According to the doctor, your official diagnosis is now a pulled muscle." I couldn't stop smiling.
Robert hugged De Anna so hard I was sure he'd break her ribs.
"Let's go home, Honey. We got a wedding to plan!"
I insisted on being the one that took Robert downstairs in a wheelchair. After he was sitting in the car, De Anna came to me and gave me a hug.
"Mary, we want you to come to our wedding, if you can. It's not going to be a big affair; just people that mean the most to us will be there. We would be honored if you would come."
Tears clouded my vision.
"Well, send me an invitation and I just might."
I watched as they drove away from the hospital and they waved until they were out of sight.
Five weeks from that day, I attended a wedding. De Anna was beautiful in her dress with the long train trailing behind her as she walked down the aisle. Robert was handsome in his black tuxedo, wearing the biggest smile I've ever seen as his bride walked toward him.
The words of the wedding vows had never seemed so poignant before.
With tears of happiness, they both joyfully repeated, "…in sickness and in health, till death do us part…"