up & down & all around : a month on the bone marrow transplant unit

Sunday, September 30, 2012 | | 0 comments
thirty years have gone by and i continue to learn more about myself every day.  i find this particularly true in uncomfortable times, times that leave me evaluating the whys and the hows, times that challenge me.

for the past month, i've started each day at the shiny front doors of the cancer hospital.  i've walked through the marbled front lobby, by a coffee stand with hip baristas and wafts of comforting smells.  i've ridden the elevators, often alone with my thoughts, straight to the 7th floor. the bone marrow transplant unit.

the bone marrow transplant unit. a place i'd never been but a few times prior to the start of my fellowship.  as a resident, this was place as foreign as the moon....a place very few of us ever wandered.  the only time i had ever seen the inside of the unit was with tired bloodshot eyes in the wee hours of the morning as an intern working in the MICU.  i had been a doctor for all of 4 weeks and was still frightened to order things as simple as electrolyte replacement.  on that particular night, a transplant patient needed our help, and badly so.  i had never seen someone so sick in all my life and the rapidity of the decline terrified me. an older woman with acute leukemia, she had recently received a lifesaving disease curing stem cell transplant from her younger sister.  the transplant itself had gone well but after weeks of a very frail and nearly nonexistent immune system, she succumbed to the ravages of overwhelming infection and eventually died in the intensive care unit during those first few weeks of my intern year.

i would be lying if i said that the first morning of my rotation, now 3 years, 2 babies, and one residency behind me i wasn't still terrified.  i hid it well behind my latte and my brand new cardigan.  but i was scared. a different blend of medicine is practiced beyond the walls of the transplant unit....one where the basic rules of medicine often don't apply, uncommon is common, and we often take patients to hell and back for the sake of a chance.  a chance, better in some instances than others, that the cancer might be completely cured {if only for a short while}.  that life might be normal again, {even it it's not forever}. that chance often comes with unimaginable consequences and we deal with those too, together with patients and families who never dreamed they'd find themselves here.

as you can imagine, complicated medical problems aren't the only things that fill the halls in this place.  emotions, unspoken and otherwise, fill the patients' lives and their rooms ~ ones where they often stay for months at a time.  i've never felt the raw emotion more than in this place. the what ifs, the questions about time left, the thoughts on life lived, the prioritization of the moments to come.....they overflow and bathe everyone involved in the care of these patients with fuzzy sense of connectedness.  one that i can't quite wrap my fingers around or express appropriately but undoubtedly permeates everything.

what i see more clearly now is that the difficult moments, the painful conversations, the moments when i'm caught off guard.....they are the ones i allow me to do what i do.  when i'm not able to face these moments with patients, to help them process the impossible questions....it hurts my heart, from the inside out.  i need it quite possibly as much as they do.  maybe that is an obvious and selfish revelation, but it's my truth nonetheless.

so it has been a month of ups and downs and all arounds, both medically for these patients and emotionally for us both.  but i'm stronger and perhaps a bit wiser for it.

the day before my rotation was to end, i got separate sets of news that tore my heart in opposite directions.  a dear friend of ours received news, shocking and horrible news, that his father died unexpectedly that day....a rainy thursday, at least here in florida.  i exchanged confused texts with his wife, my best friend of nearly 30 years trying to make sense of what was happening.  why? how? what can we do? i got off the phone with her that afternoon ~ struck with my complete inability to take his pain away.  paralyzed by the fact that there is nothing i can say, nothing i can do to make is heart not hurt.  they hopped a flight to illinois the next day and are there now trying to make sense of it all while we are here praying for peace to befall him.

shortly after this news, another dear friend and her husband who have been struggling for the past 2 years with infertility learned that they are expecting a *healthy* and perfect little one this april.  we met for hot chocolate on that rainy afternoon and i nearly cried clutching that strip of shiny ultrasound paper in my hand.  i saw joy in her eyes and heard it in her voice and it filled my nearly empty emotional bank account right up.

as i left the hospital that day, passing several expansive windows en route to the elevator bay, a rainbow stopped me dead in my tracks.  it was almost too perfect to be true. piercing through the shimmering rain it literally touched down right in front of the hospital.

i've never seen anything quite like it and doubt i ever will again.  sounds a whole lot like my month on the transplant unit.

sunday funday.

Sunday, September 16, 2012 | | 0 comments
today called for a play date!  emma's friend kelsey {and her mommy too!} joined us for some afternoon fun.  both girls had gone nap-less which is always fun....but despite this, they had a great time.  kelsey's mom, jen, is one of the senior heme/onc fellows in my program and one of the nicest human beings i have ever met.  {she just so happened to be my chief resident when i was pregnant with emma....kelsey had been born just 6 months before so she and i became first time mommies at nearly the same time!}  she's a great mommy, a fabulous doctor, and a wonderful sounding board for me as we simultaneously travel this amazing mommy-doctor journey and strive to find a daily balance between all the roles in our lives.

there was laughter, lots of jumping, dress up and pretend.  both girls were clearly tired since they had chosen to evade naptime (go figure) but we got away with only a few minor tiffs.  emma is learning to share her toys and has a ways to go (just ask her brother!)....but made some concessions in the end :) kelsey was a champ and it was only appropriate that she left the house dressed in emma's wonder woman costume.

a cozy sunday

Sunday, September 9, 2012 | | 0 comments
the kids are eating syrup laden pancakes and ryan and i are clutching dangerously strong cups of coffee.  i love sunday mornings more than anything.  it is calm in the murphy house for a brief moment and we are soaking one another in before the day grows into its usual glorious mess.  such is life.

i don't have much to share on this dreary morning.  we were all woken in the wee hours of the night to bright flashes of lightening coupled with monsterous claps of thunder so loud it felt as if the storm was right on top of us.  the drizzles remain and we are all cozying up to one another.

this feeling, this closeness....this is love.

i stumbled upon this quote this morning and though i would share it as both a reflection and a thought to carry with me through the week.

happy sunday to you all.  it's a great day to be alive.

"I beg you to have patience with everything unresolved in your heart and try to love the questions themselves as if they were locked rooms or books written in a very foreign language. Don't search for the answers, which could not be given to you now, because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer." 

- Rainer Maria Rilke, Letters To A Young Poet

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