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.
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