As I was told “Kevin has cancer,” waves of emotion rushed through my being with such force that I felt as though I was drowning. To this day, I still feel engulfed, dizzy, weak and utterly helpless. Cancer! The death – painful death – disruption of life, disfigurement, discomfort, and the prolonged treatment of cancer seemed worse than the burdens of most diseases.
My brother’s cancer has metastasized, I’m told, but other than the lump on his neck and a little shoulder discomfort, he feels fine. How can he be so young, just thirty-five and so apparently healthy, yet have this horrible demon in his body? Why Kevin? He’s so good! It’s not fair!
But, I’m a nurse. I can help him. After all, I’ve worked with lots of cancer patients, many of them young, like Kevin. During my initial conversation with him I decided to swallow my emotion, fight back the tears and summon every bit of reserve that I possess. At a time like this I can’t permit myself to be a weeping, hysterical woman. I must be helpful, though I feel helpless; supportive, though I feel weak – Kevin needs me!
My thoughts continue…the doctor told Kevin that he has a chance for cure…in spite of the metastasis? …I wonder. Intellectually I know that cancer is not a “death sentence.” That is a myth. Many patients are successfully treated for cancer and continue to lead healthy, productive lives. And the doctor did say he had successfully treated other patients with Kevin’s type of cancer. Kevin is young, he is strong and he has the will to survive. There is hope! I dust off the shackles of helplessness; my direction is now perfectly clear.
I will begin by teaching him how to be a patient. He had never been this sick before and doesn’t know what to do. First, I must find out what he understands about his illness so that I can help him identify and clarify the many questions he must have. His physician gave him adequate preliminary explanations, but how much did Kevin really comprehend?
Next, I can help him understand his rights as a patient – the expectations he should have regarding the quality of his care. I can assure him that he has the ability to be his own best advocate, that it’s acceptable to ask question and appropriate to make his needs known to health care professionals. Finally, I can offer him realistic hope and encourage him to muster all his available resources to fight what is sure to be one of the biggest battles of his young life.
As the reality of his cancer continues to make its impression, I can listen, explain and show in many small ways that I care. That doesn’t seem like much, but the more I’m with Kevin, the more I’m convinced that small kindnesses mean as much or more than sophisticated technical skills.
Being with Kevin has validated fundamental beliefs about nursing that I’ve held and tried to practice for years. Each patient is a person, an individual having a personal response to a unique illness; a person who reacts to sickness with his entire physical, psychological, social and spiritual being; a person whose plight the nurse most likely can’t fully comprehend, no matter how caring and empathetic he or she may be; a person who evokes feelings of inadequacy in the nurse because nursing interventions seem bereft of the power to heal.
The moment we’ve anticipated since Kevin’s diagnosis has arrived; it’s time to initiate chemotherapy. For better or worse the I.V. is started, and as the saline infuses, Kevin and I share a common, though unspoken fear of the new ordeals that chemotherapy will most certainly bring.
Finally the chemo is started – and we watch and wait – the poison drips in, slowly but surely – and we watch and wait. It’s true, Kevin really has cancer! If he didn’t why would be subjected to the rigors of such treatment? We watch and wait.
When will the dreaded side effects begin? Will he immediately become nauseated and vomit? Will it be today, tomorrow or next week? And what about his beautiful, thick hair? If he had a choice, he’d suffer the ordeal of incessant vomiting, if only he wouldn’t have to lose his hair. We watch and wait. “A small price to pay for my life,” he says smiling in his typically nonchalant way.
It’s quite apparent that Kevin’s illness has intensified values I’ve long held about nursing’s contribution to patient care. However, because Kevin is my brother, I now have insights that can only be gained through personal experience. These I share with you, my nursing colleagues, to broaden your perspective in the hope that your own nursing practices will not require the suffering of a loved one to achieve enhancement.
Cancer is a devastating disease, which, like a thief in the night, robs its victim of health and vitality. It threatens a life that is loved and valued by the patient, his family and friends. By virtue of their education, socialization and availability, nurses have the opportunity to help patients fight seemingly insurmountable odds. Wellness and good versus the formidable foe – cancer!
Patricia D. Croot, MSN, RN
Instructor, Riverside School of Professional Nursing
Sadly, Kevin died on May 15, 1989 at the age of 36. The day before he lost consciousness, we talked about death – its loneliness and great unknowns. Moments after he died, his handsome face, horridly distorted by edema, returned to its pre-illness beauty. It was then that I knew Kevin was in heaven. That was Kevin’s last great gift to me, and truly a gift from God. In the years since his death, hardly a day passes that I don’t feel his presence in my life.
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