Imagine simply walking out the front door right this moment only to find yourself returning home weeks to months later. This is often the reality for many newly diagnosed cancer patients when visiting the emergency department to discover an abnormal lab result guaranteeing them a stay in the hospital. Whether it be the need for a blood transfusion, urgent chemotherapy, or the discovery of immunosuppression, many patients newly diagnosed with cancer often have an unexpectedly long first hospital stay.
This is the story of the patient I will never forget. One patient’s cancer journey started by traveling in an ambulance to the hospital on New Year’s Eve, ringing in the new year by being transferred to a new hospital bed. On New Year’s Day, I welcomed her to the Malignant Hematology Unit. We knew the preliminary lab work was abnormal, but we were still awaiting additional results. During the COVID-19 pandemic, the hospital doors were locked, and no visitors were allowed. Therefore, I spoke to her family members on the phone, reassuring them their loved one was safe. FaceTime and phone calls were the main connection between the patient and her family; this was also how we notified her family that the diagnosis was malignant.
When it was time to start treatment, I had the privilege of administering this patient’s very first dose of chemotherapy. Administering chemotherapy on this inpatient floor is often routine, yet for many patients, this task can be a very big deal. I could tell my patient was nervous, afraid, and possibly even excited all at the same time. However, with no family members allowed on the unit, I recognized she would be enduring her first treatment without the comfort of a familiar face.
As I prepped to place the chemotherapy on the IV pole and connect it to her central line, I said, “Why don’t you pick out a song to play.” She instantly turned up the volume on her phone and played the song Happy by Pharrell Williams. This song instantly brought a smile to both of our faces. Being her nurse was my favorite time of all. We celebrated many big moments with ice cream, such as when a donor match was found for her stem cell transplant to having a ‘clean’ bone marrow biopsy result free of cancer cells.
Fast forward a few months later, I saw my unforgettable patient’s name on the admission list for the day—as a scheduled admission for a stem cell transplant. I was getting off the night shift that morning and was not scheduled to work for a week due to a planned vacation. I thought to myself, this cannot be happening, my vacation cannot be the same week as her bone marrow transplant. I decided to write her a letter of encouragement for transplant day with the reminder that I would be back in a week. Before I left, I placed the handwritten letter in her room for her to find upon arrival as I wanted her to know I would be thinking of her and sending positive vibes for transplant day. When I returned from vacation, I was able to partake in the excitement of new stem cells by discharging the patient to home post-stem cell transplant.
However, a few months later, our paths crossed again. I remember the day she looked me in the eyes with defeat to say the cancer was back. We tried a different course of treatment and luckily visitation at the hospital was reopening with one visitor allowed at a time. We were finally able to communicate with her family in person rather than over the phone.
Although many treatments were started, the cancer remained. During her last hospital stay, there were no more treatment plans to choose from. The final decision was made for her to return home to be surrounded by loved ones. We had one last heart-to-heart a few nights before she was discharged home on hospice. I asked her how she felt, and she said she was ready. I noticed the unsteadiness in her voice and the glistening of tears in her eyes.
I told her how proud I was of her. We reminisced about her cancer journey together. We laughed about the time I told her she was too young to not be walking the halls every day. I sat down next to the hospital bed, and she noticed the worry in my eyes. She thanked me for taking care of her and being a friend. We always talked about the end goal of ringing the remission bell at the end of treatment. That night, she looked at me and said I am ringing my bell, it may not be the one I imagined, but I am ringing my own bell. On her day of discharge from the hospital, she rang her hand-held bell all the way from her hospital room to the elevator doors to say farewell.
Days later my unforgettable patient passed away. As I was walking in the park later that day a butterfly crossed my path. A symbol of hope in search of the light. Butterflies may have a short life, but it is always a transformative and beautiful one. I will always remember this patient as courageous, strong, and with a big heart. Some people can leave such an impact on our lives, that even when they are gone their light shines a little longer in the hearts of others. To my butterfly-loving patient who always found a reason to celebrate, I will never forget your story.
