Around Midnight in the ICU

Tuesday, November 22, 2005

Exhausted tonight...

Some days go on forever. Some nights we don't sleep. Some patients get an answer the minute they waltz into the emergency room. Some people get admitted. Some nurses come looking for answers they can't find anywhere else. Some diseases you can treat. Some symptoms don't make sense. Some families make you laugh. Some blood gets lost in the lab chute. Some CT scans get shot out of sequence. Some tears fall on deaf ears. Some faces are scarred. Some limbs are repaired. Some wounds never heal. I looked at the lab results two or three times in disbelief. They clearly showed the paucity of cells. Every line was down. Only three things I know of that do this, and they are cancer, cancer, and vitamin deficiency. Maybe the blood tests from three weeks before will help, the old man proffers as he hands me the papers. His mother is a cancer survivor. She battled squamous cell cancer of the sigmoid for two long hard years. She underwent a local surgery, resection of a tumor which was too deep to warrant complete removal. She did the chemotherapy, even though that nearly killed her. Then, she put herself through the radiation, gobs of it, as she tells me. That was eight years ago Sonny and I'm still yipping! Only the yip has been gone for about a month. She is too tired to walk across the room now. The lab tests from three weeks ago clearly show what I fear. The radiation has predisposed her to lymphomas. There are blast cells on her smear, indicating the conversion of a lymphoma to acute leukemia. The physician who reviewed this did not tell her about the leukemia. He told her nothing. The yip did not come back, so three weeks later she came knocking on my doorstep for a second opinion. Some physicians are cowards. They will sidestep the truth. Or they'll wait until their patient is sick enough to warrant a trip to the emergency room, where they officially become someone else's problem. This lack of yip dilemma became mine very quickly. No more dancing, so we all told her the brutal truth. Not very hospitable of us. Not very Texan. We told a woman who had fallen on our doorstep asking for help that there were no vacancies. There is nothing we can do for you. Go back home. Pray. Maybe, if the good Lord grants that miracle, you'll live another month. Arrogance, almost. But she knew, deep down inside. So she stays with me two days, a guest in this house, gets an opinion from the oncologist. When it's over, she leaves. She goes home to die. But I am not sad. I am hopeful for her. It's Thanksgiving, and she will spend it with her four children, twelve grandchildren, and two new great-grandchildren. Some people are afraid of death. Really, death is just the end of one journey and the beginning of another. That's the miracle. The yip comes back. If I don't believe that, a part of me dies with every one of these little old ladies in the emergency room. Some nights we don't sleep because we forget this. We become afraid of the darkness. But then I remember. I know that all of our days go on forever. I give thanks for this little piece of mind that holds it all together, keeps my sanity. Everyday, not just Thanksgiving.


  • Neil Gaiman, in his Sandman series, had a character say a very wise thing at a funeral: "I regret the conversations we never had, the time we did not spend together. I regret that I never told him that he made me happy, when I was in his company. The world was the better for his being in it.

    "These things alone do I now regret: things left unsaid."

    I have tried to take these words to heart and never leave things left unsaid. When somebody dies, if you have not left things too long, it is easier to grieve, as I can see from my father-in-law's funeral last year. Everyone there had long been careful to say and do the important things, so though his passing brought sorrow in its wake, there was no overlay of regret.

    By Blogger B. Durbin, at 10:19 PM  

  • Holy WOW.

    The poet in me admires the way you've structured this post. The hospital chaplaincy intern in me looks at the last several lines -- "Really, death is just the end of one journey and the beginning of another..." -- and wants to weep. Thank you for this.

    By Blogger Rachel, at 10:43 AM  

  • Hujefa,
    I didnt know you were out "here"---aziz helped me find you. :)
    HOpe you are well..

    By Blogger maria, at 12:46 PM  

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