I sat with my patient to discuss her progressive disease. It has now spread to many sites and it was deemed incurable. We had done several tests, and that much was certain at this point. I sat across from her and her mother. I started the conversation about treatment, but I felt I could not complete it. My patient got distressed and was no longer receptive to the information I was trying to relay. In addition to the tears in her eyes, the air between us felt foggy. I was not expecting her to “bounce back” and be with me in the session just yet. I wanted to say, “Go home come back in a week”, but I find that most patients want me to still speak after they’ve mentally left the session. They want me to go on a soliloquy penetrating the fog. I find that most want some instantaneous miracle to come out of my mouth. It saddens them further when I do not have that miracle. But I have to get through this conversation about the treatment, to get some sort of plan in place. All I want to say is go home and come another day.
Her mother took center stage with tears in her eyes and started asking questions to make sense of the decisions that needed to be made. Another set of ears to determine the next course of She pulled me in and pushed on the discussion in the midst of the fog that now clouds the mind of my patient. My patient was tearful, and her mind preoccupied and weary of what she is about to face. What do you say to someone who is young who has been robbed of the years yet to come?
A fog is blinding, the road that was clear is now murky. There are many dangers. I have never liked driving through a foggy day. I always say when it will end, having always to remind myself that it will eventually end. My eye sight limited, my vision obscured. My senses are heightened, ready to react, and my fears accentuated. I can only imagine the burden a diagnosis such as this places on the patient. When a fog descends upon your life, it’s not a highway, a road or an alley, but rather your life. I reflected on this, as drove in this morning through the thick fog that had engulfed Iowa City. The clouded roads, nowhere to hide from it, affecting everyone. I know that it eventually lifts but sometimes the feeling that it will not, overpowers. That is the time I wish I could tell my patient go home, and come out when the weather clears up.
I can’t lift the fog even if I try. The fog is in front of your eyes. The fog is in your way, the fog is in your life right now; but I know it will lift one day, and I hope that day is soon.
May 1st kicks off Melanoma Awareness Month. Guest bloggers will take over my blog on May 7th, 14th and 21st and share their stories of melanoma. I will wrap up Melanoma Awareness Month by blogging on May 28th. Monday, May 5th is Melanoma Monday and the American Academy of Dermatology asks that we all wear black to bring awareness of this disease. Take a photo of yourself and upload it to my Facebook page, Melanoma Iowa, on Monday to show your support.
Stay out of trouble
Let’s all laugh. It’s infectious, heartwarming and welcomed. At any time during a conversation. Throw a joke, a comment that grabs attention, a statement that has everyone doing the same action. Laughing with our hearts together as one. Today I was pleasantly taken by surprise. I walked into a room with the most delightful patient. She was on fire. Exploding with one comment after another like she was doing a standup comedy or as she said it “I’d prefer to sit down”. It was my turn to laugh. She had me reeling with laughter till I almost cried. My turn to be entertained. I loved her spirit, her joy, her courage to laugh, to face her cancer head on and to live life fully. She told me of her preparations for her holidays, of her family that was coming of the adventures she will have with cooking, food and sleeping bags.
I needed that laugh. It removes my callous nature when faced with the extremes of this disease. Like a massage removing the tense conversations after a long day. Helping me fall asleep relieved and relaxed. Yes it makes a difference to us all in the field. To be able to laugh with you about such an ordeal. For you to see that as a way to connect and share your thoughts and secrets. You amaze me. Your insecurities and our inefficiencies the food for our amusement. But you make it happen. You add the spark. You allow me to build on the fun of it. And you share with ease your feelings about how when faced with such an adversary that you laugh. I have only you to thank for that.
I love it when I was told “I’m 3 years disease free now, I am glad you have me to feel good about your day”. And I do feel good about that. That you all are out there, showing me the positives of our fight; that you exist. It’s like you better exist, how else could I be who I am? So I urge you, make fun of me, laugh with your heart, share with your smiles and come together as one. And if you really need to just give me a punch, you know the one I promise; I would never punch back. It’s my way of sharing with you the ability to overcome your greatest fear, of being left alone to deal with this disease.
You are definitely not alone. You are family, thank you for making me find laughter even in the midst of the hardest time. For that I hope you soar, high and you roll in laughs as you fight your battle against something that can never take that away from who you are.
Light when it strikes a prism splits into many colors. We are all faced with life’s challenges that shape how we face our daily lives. How does cancer affect the mind of the person afflicted? How does cancer shape the lives of those who survive it? They are clearly not the same as when they started. They just missed death because they were forced to entertain its existence and question their mortality. They rose above the fear of loss and planted their feet firmly on the ground and walked the journey being asked of them. Many struggled, many questioned. In this journey, how do I fit in?
Besides wanting to be a garbage man I have often thought I could be a comedian. I only come alive in front of my patients. I feel the stage, the connectivity and the ability to find in them their strength, harnessing it to help them fight. How do I write to make me sound funny? To relive the moments that I connect with my patients, throwing jokes and fun statements to keep their morale up so that they can clear the hurdles that stand in their way.
Today my patient cried and giggled. She was half way there. A treatment with a good outcome but very long nonetheless. When I walked into the room she sat hidden behind the curtain calling out that she was not crying. I could hear the choke in her voice. I pulled the curtain back and started my act. I pulled the stool in the room and sat close reaching inside of me to find any word that would make her laugh. Comments on my beard that I was attempting to grow, on why she did not bring her cat with her and how her brother too tries to make her smile. Between tears and laughs we reformed the bond. I could see her pick herself up from falling down and saying ok I am ready for the chemotherapy. I thought when she survives this and moves on, will she remember how many laughs we had? Or would that be a forgotten memory?
When I see my patients survive their disease, these laughs that helped them through tough times solidify a trust in me that make me believe I do make a difference. I hear it enough times and I share with you honestly and openly that I too forget. I forget their struggle, their fight. Perhaps it is the joy of walking in and telling them that they are still disease free and that they are winners that makes me forget. I see in them a wisdom that was not there when they started, a strength that I know makes them face life differently and knowledge that they just beat cancer.
Why would I want to remember how they struggled? When they are truly the winners.