“I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one's head pointed toward the sun, one's feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lays defeat and death.”
~ Nelson Madela, Long Walk to Freedom: Autobiogaphy of Nelson Mandela
Most of my Facebook friends know my mother has been battling cancer for over 6 years now. She is being treated at the IU Health Indiana Cancer Center on Indy's southside. She recently had surgery, and has been doing very well. Today she went in for a follow up visit with her oncologist-- no planned chemotherapy. I went with her because she still isn't allowed to drive. My independent spirited mother fusses over this-- she is used to just driving herself over there, getting whatever care or treatment is needed, and driving back home. However, we have paired this kind of outing with lunch together at a local restaurant, so we have fun. I do anyway!
Today the Cancer Center was very, very busy. We knew when we pulled into the full parking lot it was going to be busy. The usual procedure is for Mom to be weighed, labs drawn, then wait in the treatment room until they have an exam room where she speaks to the oncologist. The first stuff-- the weigh-in and lab draws-- were done promptly. Then she and I sat in the treatment room for an hour waiting to speak with the doctor.
The treatment room is a long, narrow room with one long wall of windows that look out onto an enclosed garden area. There are lots of bird feeders out there and flowering shrubs. Sunlight streams in. It reminds me of the old "day rooms" at the original (now torn down) University Hospital in Ann Arbor where I went to nursing school. The long wall is lined with treatment reclining chairs-- probably 10 or more of them. Usually there are one or two people in them when we get there. Today they were all full except the one right by the main entrance door to the room. Mom sat there and I sat in a nearby visitor's chair. There was a lot of ambient noise, so conversation with Mom was difficult (she suffers from hearing loss-- as do most people her age!) I could only sit quietly and observe. I found myself marveling at the people in there and thought I'd share some of what I saw.
In about the middle of the room there was an older man in a recliner, sitting way back in the chair. He was hooked up to IV tubing that went through an electric pump to what is called a "port". A port is a device implanted under the skin that allows special IV needles to be stuck into it. It is placed in one of the larger blood vessels in the shoulder area. Having one of these means that the patient does not need to have their veins stuck every time they need blood drawn or an IV infusion begun. It all goes through the port. It also allows chemotherapy drugs that would literally fry the tissue of smaller blood vessels to infuse into a large one and become instantly diluted and thus avoid tissue damage. My mom has one, and it has meant treatment is much more comfortable for her. Anyway, this man had an IV going into his own port, and a second tube was going into his abdomen. He lay in the recliner bare-chested, with both tubes working their "magic" on what is probably some kind of GI cancer. Sitting next to him was an older woman, who I presumed was his wife. They were not talking to one another. The man lay with his eyes closed. The woman sat in silence and dabbed at her eyes. I noticed her eyes were red because she also was wearing way too much eye makeup. It was almost Cleopatra-like with very black thick liner and dark, penciled brows. Mascara ran down her cheeks. She sniffled occasionally, looked a few times at her husband, but mostly just looked off into space. It struck me that this woman was dealing with bigger issues than just the day. Perhaps they had already spoken with the oncologist. Perhaps they had been given bad news. Perhaps she was thinking about something in their past... whatever, it was a hard day for her.
In the chair next to this couple sat a tiny, older woman. She was very tiny except, oddly, for her feet, which were encased in very large white athletic shoes. Her legs were terribly skinny. She read a book and occasionally looked up to smile at people. She had an infusion going in the port in her shoulder too. Later, when it was finished, the nurse disconnected it all and the woman was free to go. It was then that I really noticed the wheelchair for the first time. It was adjacent to her treatment chair. She raised herself up using her thin arms and hoisted herself from one chair to the other. Once in the chair, she began to push herself toward the front exit. Her nurse stopped to offer help, and pushed the wheelchair toward the front waiting room. I overheard the patient telling the nurse that So-and-so was on her way to pick her up, but it would be awhile. Apparently this tiny, ill, frail woman lived alone and was relying on someone to transport her to and from the center.
A new patient was ushered past. She was a tall, very young, moon-faced young woman with very thin extra-curly hair. Her moon face was probably due to some kind of steroid treatment, and the thinning hair was no doubt from chemotherapy. She looked to be no older than her mid 20's, perhaps even late teens. She chattered to the nurse as the two of them walked past.
An elderly couple arrived. He looked quite old, but seemed in good health. She was pushing a wheeled walker, and had a severe osteoporosis hump back. Barely able to look forward, she maneuvered her walker through the chaos of the room to the bathroom. While her husband was waiting on her, a maintenance man from the center greeted him. Apparently they knew one another well. The woman emerged from the bathroom and chatted with this man too. There was some merry laughter and her voice was strong and cheerful-- it belied what her physical appearance suggested. She was escorted to a treatment chair and an IV infusion was started in her port. She chatted and joked with the nurse, much to the amusement of the woman with too much makeup on, who was sitting in a chair next to them. This was the first time I had heard this woman speak, and to see her smile was a bit of a relief to me (I had imagined all kinds of awful things!) Clearly, this humped old woman was a favorite here, and it was easy to see why. She dispensed cheer like the nurses dispensed chemotherapy!
Another younger woman, probably mid-40's, walked in alone. She was carrying a stack of magazines, and dumped them in the chair next to my mother. She was off to the bathroom. When she came back, she stopped at the snack area. This area consists of a coffee pot and then two baskets of assorted snacks-- those packages that hold 6 Lorna Doone cookies or peanut butter crackers. This woman took 3 packs of snacks, and I couldn't help noticing that she talked to herself the whole time she was there. She walked back to her chair, sat down with a plop, fiddled with the magazines, fiddled with her sweater, stood up, walked back to the snack baskets and found something else, returned to her chair and plopped down in it again. Back to the bathroom, talking all the while. I remember thinking "Please... stay away from the coffee! You are too wound up as it is!" I suspect she was a nervous person anyway, and being where she was exacerbated that a lot. A nurse returned to take her vital signs and draw some blood. This lady did not have a port, so the nurse had to stick her arm. Since there was to be an IV, the nurse attempted to draw blood from the same vein that would be used for the infusion. It didn't go well, and eventually the nurse got a fellow nurse to help her. I overheard the patient asking for them to avoid her left hand, as that was sore "from last time". I remember thinking how glad I was my mom had a port! Eventually they got the blood drawn and the IV infusing. This woman settled down with her magazines and snacks.
Eventually they called my mom to an exam room where she had a discussion with the oncologist. We lovingly call him "Dr. B" because he has a foreign eastern European name that is difficult to pronounce. He is an energetic and sincerely optimistic doctor, who has called my mother A Miracle, so we enjoy our discussion with him. Eventually we are allowed to head for home, which in our case means we can head for our favorite lunch hangout.
Now that I am home here in Avon and my mother is home down in Greenwood, I find myself thinking about all those people we saw today. And all the nurses who were working very hard to treat these patients. I was struck first with the overall optimism I found in this place. Cancer used to be a death sentence. Just the word was whispered rather than said aloud. My mother, The Miracle Patient, has turned her own cancer into a chronic disease that must be dealt with, but not feared. Her optimism is due, in part to her basic optimistic outlook on life. But also, I think, it is due to the oft-verbalized optimism of her physician and to the staff that work at the Cancer Center. They are exceptional! Always smiling, teasing, laughing. They give hugs readily. And on one occasion they listened to my mother when she had to say her favorite curse word (she asked their permission first. It was given... and then they said it too.) The patients I saw today, some in extraordinarily frail shape, all seemed to gather a strength there to get on with their treatment. It didn't matter than hair would fall out or that tubes were sticking out of body places that didn't normally have tubes... the patients and families all seemed to catch the spirit of "let's get this done so I can get on with my life". What a remarkable gift that is to give to some very needy people! And how proud I am to be a nurse when I see other nurses performing at this level. Thank you to the staff, nurses and Dr. B, of the IU Health Indiana Cancer Center on the southside of Indy. See you in two weeks!!
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