News That Will Never Be Good To Hear

All of my patients struggle with cancer.
Some have active cancers that require treatments, some that have operated on waiting for the shoe to drop.
I want to focus on the latter part of the population.
I find it incredibly hard to take care of them more than those with active disease.
Comforting them and reassuring them is difficult and when we find recurrence of disease and have to tell them .. That is difficult.
NO matter how well you deliver, it will be bad news.

Into the Storm

It snowed all night from 11 PM and continued throughout the following day and night.
It took me perhaps only 30 minutes more than normal driving time but it was indeed getting quite "bad" out there.  I arrived  at the Cancer Center in the snow storm.  The Cancer Center Control Center recording clearly noted that "it is fully operational" that day.  I knew there would be cancellations but knowing our patients, there will be a decent amount who will show up for their appointments or treatments.

As I got out of the car, there was our parking security officer waiting for me.  She asked me where I was going.  I told her that I was heading into the Cancer Center form the parking lot.  She asked me to be "very careful" not to fall or slip.  " I don't want my nurses and doctors to fall and not be able to see the poor patients",  she said to me.  I felt grateful for her concern and we started to walk together towards the building.  We began our conversation with how the snow was beautiful coming down but the driving in it is just terrible.  She then said, " I wonder if a lot of patients will cancel today or not". My reply was I didn't think so unless it was just a routine  visit.  For those with scan results to go over and to receive treatment would  surely come.  She said she could not understand why the patients are putting themselves in danger in the snow and come out all the way.  Her husband was also a cancer patient in the past, dead or alive she did not say, and she said they argued when the weather would be horrible.  He always insisted going for treatment no matter what.  She could not even convince him for one or two days of delay in treatment.  If the Cancer Center was open, he was going.  She at the end said did not argue but she took him for his treatments no matter what the weather was outside as long as the treatment center remained open.  My reply to her was pretty generic at first.  " I know, it is so dangerous to be out and driving and one or two days of delay in treatment doesn't really matter in the big scheme of things... But they want to be here no matter what. They have cancer and they are focused on getting better."  Then it hit me. It does matter.

As I walked to my office and all day, I could not get that, "it does matter" part, out of my head. I thought about it and thought how careless I was to think that it is crazy that these patients are here putting not only their lives in danger but their drivers' as well.  But it is not that.  They are fighting for life against death.  For them, treatment IS the life line.  Deep in their hearts, they know and they worry about the weather and the road and that perhaps this treatment might not work.  I am sure they feel a bit of guilt by asking the loved ones to take them in for treatments in the storm.  For those of us who are not in their shoes, we are just rationalizing the situation and think "safety first, stay off the road".  But we are not fighting for our lives or trying to live a bit longer to be with loved ones and perhaps just hope to be here for the family dinner on Easter Sunday.
When I was a young nurse, I remember one of my preceptor telling me try not to say, " I know or I'm sure" as empathetic response because we do not know but we can only imagine how they may be feeling. It is true. I learned not to say those two things to my patients when they receive bad news.  It seems almost arrogant to say those words to the patients.

I can imagine now after a long day of thinking, the determination of the patients making their ways to their visits and treatments.

I drove home into the snow storm as our patients would have as well.
I hoped that all on the road got to their destinations safely for they traveled into the storm to get their hope for perhaps another month or another 3 months before the next scan.... or maybe just maybe a hope for that cure.

I was glad to have met the parking security officer that day....