Chicken Soup for the Nurse's Soul (21 page)

E. E. Hale

He’d come for minor surgery, a simple patch-up job. A piece of cake, really, unless you have a history of hemophilia and HIV, a legacy of contaminated blood. What started as “routine” spiraled into complications—needles, tubes, a ventilator—trying to sustain a body that would no longer sustain itself.

He came to us for end-of-life care—pale, hunched over, breathing hard, a feeding tube hanging uselessly from his nose. Fifty years of life condensed into a slim chart of medical relevance: an admitting sheet, history and physical, progress notes. Bare facts: prognosis poor. Running out of options. Running out of time.

His family came to him and knelt at the bedside, their faces wet with knowing. Touching. Talking. They wrapped their arms and voices around him in a passionate effort to keep him connected to this world.

“I want to go home,” he said. “I want to go home to die.”

Health-care professionals often toss around phrases like “comfort care,” “supportive intervention” and “the patient’s right to self-determination.” We say them as if we know what they mean. But what did they mean to this man and this family?

“I want to go home. I want to go home to die.”

His family came to us for help in achieving that wish. They knew it would not be easy, as did we. They knew there were no home-care arrangements in place. They knew his blood pressure was fifty-four over zero. They knew home was an hour away; not a vast distance by most standards, but a tremendous journey under these circumstances. They knew, too, that there was a strong possibility he could die in the ambulance.

“It doesn’t matter,” his family said. “He will know he is on his way.” In that knowing, perhaps, lies the ultimate “comfort care.”

And so, we, his medical team of nurses, doctors, social workers and more, blended our planning efforts. We were all participants in this last leg of the race. There were discharge orders to be obtained: morphine, oxygen, a home hospice nurse visit. There was urgency, pressure and determination. Voices were raised and minor misunderstandings occurred, but despite the glitches, a major victory was achieved.

Two hours and forty minutes after we began our efforts, the ambulance arrived. Making an exception to policy, they allowed two family members to ride along, in case death came too soon.

Our patient made it home by two o’clock that afternoon. Four hours later, he died a peaceful death in his own house, in his own bed, with his family present and his dog curled up at his feet.

Martin Gray once said: “We never believe enough in ourselves. We are forever ignorant of the resources of life. But life is to dare to break through the walls that we erect before ourselves. To transcend the limits we impose on ourselves. Life is always to go beyond.”

I believe each of us in health care has the opportunity to assist people in how they want to live, and sometimes, in how they wish to die. All of us have a stake in that process. When we bring our gifts to the race, when we combine our gifts with those of others, we are choosing “to go beyond.” The results can be powerful, extraordinary— even transforming—for ourselves as well as the people we serve.

Anne Riffenburgh

He Conquered It

T
he conditions of conquest are these: We have
but to toil a while, endure a while, believe
always and never turn back.

William Gilmore Simms

There are angels on this Earth and they come in subtle forms, and I decided LaTrice Haney was one of them. Outwardly, she looked like just another efficient, clipboard-and-syringe-wielding nurse in a starched outfit. She worked extremely long days and nights, and on her off-hours she went home to her husband Randy—a truck driver—and their two children—Taylor, aged seven, and Morgan, four. But if she was tired, she never showed it. She struck me as a woman utterly lacking in ordinary resentments, sure of her responsibilities and blessings, and unwavering in her administering of care. If that wasn’t angelic behavior, I didn’t know what was.

Often, I’d be alone in the late afternoons and evenings except for LaTrice, and if I had the strength, we’d talk seriously. With most people I was shy and terse, but I found myself talking to LaTrice, maybe because she was so gentle-spoken and expressive. LaTrice was only in her late twenties, a pretty young woman with a coffee-and-cream complexion, but she had self-possession and perception beyond her years. While other people our age were out nightclubbing, she was already the head nurse for the oncology research unit. I wondered why she did it.

“My satisfaction is to make it a little easier for people,” she said.

She asked me about cycling, and I found myself telling her about my bike with a sense of pleasure I hadn’t realized I possessed. “How did you start riding?” she asked me. I told her about my first bikes, and the early sense of liberation, and that cycling was all I had done since I was sixteen. I talked about my various teammates over the years, about their humor and selflessness, and I talked about my mother, and what she had meant to me.

I told her what cycling had given me—the tours of Europe, the extraordinary education and the wealth. I showed her a picture of my house, with pride, and invited her to come visit, and I showed her snapshots of my cycling career. She leafed through images of me racing across the backdrops of France, Italy and Spain, and she’d point to a picture and ask, “Where are you here?”

I confided that I was worried about my sponsor, Cofidis, and explained the difficulty I was having with them. I told her I felt pressured. “I need to stay in shape. I need to stay in shape,” I said over and over again.

“Lance, listen to your body,” she said gently. “I know your mind wants to run away. I know it’s saying to you, ‘Hey, let’s go ride.’ But listen to your body. Let it rest.”

When I had nothing left to tell LaTrice about the bike, I told her about the wind. I described how it felt in my face and in my hair. I told her about being in the open air, with the views of soaring Alps and the glimmer of valley lakes in the distance. Sometimes, the wind blew as if it were my personal friend, sometimes as if it were my bitter enemy, sometimes as if it were the hand of God pushing me along. I described the full sail of a mountain descent, gliding on two wheels only an inch wide.

“You’re just out there, free,” I said.

“You love it,” she said.

“Yeah,” I said.

“Oh, I see it in your eyes,” she said.

I understood that LaTrice was an angel one evening late in my last cycle of chemo. I lay on my side, dozing on and off, watching the steady, clear drip-drip of the chemo as it slid into my veins. LaTrice sat with me, keeping me company, even though I was barely able to talk.

“What do you think, LaTrice?” I asked, whispering. “Am I going to pull through this?”

“Yeah,” she said. “Yeah, you are.”

“I hope you’re right,” I said, and closed my eyes again.

LaTrice leaned over to me. “Lance,” she said, softly, “I hope someday to be just a figment of your imagination. I’m not here to be in your life for the rest of your life. After you leave here, I hope I never see you ever again. When you’re cured, hey, let me see you in the papers, on TV, but not back here. I hope to help you at the time you need me, and then I hope I’ll be gone. You’ll say, ‘Who was that nurse back in Indiana? Did I dream her?’”

It is one of the single loveliest things anyone has ever said to me. And I will always remember every blessed word.

Three years later, with a climb into Siestriere, I led the Tour de France by six minutes and three seconds. In Indianapolis, LaTrice Haney, the staff of the medical center and all of the patients on the ward stopped what they were doing to watch the taped coverage. As I mounted the hill, increasing my lead, they stared at the televisions. “He did it!” LaTrice said. “He conquered it. He conquered it.”

Lance Armstrong

Mr. Jackson and the Angel Pin

T
he cure for all ills and wrongs, the cares, the
sorrows and crimes of humanity, all live in the
one word “love.” It is the divine vitality that
everywhere produces and restores life.

Lydia Maria Child

Mr. Jackson wanted to die. He missed his wife who had passed away five months earlier. They had been married sixty-three years and were blessed with five children— children who were busy with their own lives. In his loneliness, he lost the will to live. He shut himself off from the world, quit eating, closed his eyes and waited to die.

Several weeks later, he was admitted to the hospital. “Malnourished,” the diagnosis reported. During the shift change, the evening nurse hastily explained the case to the morning nurse, Freddie.

“He hasn’t eaten in the two days he’s been here,” she said softly. “Hasn’t said a word either. He just looks away and stares off at who knows what. The doc is going to put a feeding tube in his stomach if he doesn’t start eating. Good luck, Freddie.” With that, the evening nurse hurried out.

Freddie looked at the frail form in the bed. The room was dark except for the soft morning light peeping through the semi-drawn curtains. The white sheets accentuated the outline of his body, which appeared to be nothing more than a skeleton draped with skin. The patient turned his head away and stared at the wall, his eyes void of hope, void of life itself.

Freddie could always find a way into the patient’s heart. Somehow, she would find the key to unlock his. Gently picking up his delicate hand, she held it in hers. “Mr. Jackson? How about some lotion on your hands, wouldn’t that feel good?”

No response. She walked around to the other side of the bed, leaned over and whispered, “Mr. Jackson?”

His eyes widened as he fixed his gaze on the pin she wore—a gold and silver angel given to her for Christmas. Impulsively he reached out to touch it, but drew his hand back. His eyes began to mist and he spoke his first words since being there. “If I had my pants with me, I would give you all the money I have just to touch that pin.”

Freddie quickly contrived a plan. “I’ll make a deal with you, Mr. Jackson. I’ll give you this pin if you will eat something off every tray we bring you.”

“No, Ma’am, I couldn’t take it. I just want to touch it. That’s the prettiest pin I’ve ever seen.”

“I’ll tell you what I’ll do, I’ll pin it to a pillow and put it next to you. You can keep it until my shift ends, but only if you will eat something off every tray I bring you.”

“Yes, Ma’am, I’ll do what you say.”

When Freddie came to check his lunch tray, she found him thoughtfully stroking the pin. He turned to her and said, “I kept my promise, look.” He had eaten a few bites off his tray. They were making progress.

When her shift ended, Freddie dropped in on Mr. Jackson and said, “I’m off for the next two days, but I’ll come by here first thing when I get back.”

His eyebrows drew together in a small frown, and he lowered his head.

Freddie quickly added, “I want you to keep this pin and your promise while I’m gone.”

He brightened a little, but forlornness still hung heavily in the room.

“Mr. Jackson, think about all you have to be grateful for—your children and grandchildren, to start with,” she encouraged. “Those grandbabies need their grandfather. Why, who else will tell them about their wonderful grandmother?” She patted his hand and hoped for a miracle.