Guest blogger Asha Kodan is a first year internal medicine postgraduate at Johns Hopkins Bayview Medical Center.
This article has been de-identified to protect the anonymity and confidentiality of the patient in the story. Any matches in names or circumstances to other patients are entirely coincidental.
If there was one word to describe Ms. S., it was purple — her silk purple bonnet, her shiny purple gel manicure, the purple water bottle always on her table. We bonded over this the first day I met her, when I walked into her room with my wrinkled, worn-out but much-loved purple scrubs. Our mutual love for the color prompted her to tell me stories about when she was a preschool teacher. She took great joy in sprinkling her classroom with bright colors in the form of posters, glitter and toys for her children.
Standing there in the beige-colored hospital room, our conversation interrupted by the occasional beeping of her intravenous pump, it was not lost upon either of us how starkly different her life was now compared to those rainbow-filled days with her preschoolers. Ms. S. had recently found out that her pancreatic cancer was metastatic, complicated by systemic infection from her chemo port and a new blood clot in her lungs. She knew her body had not responded well to the first round of chemotherapy, but now it felt like she was facing an avalanche of challenges with these new medical complications. Still, she greeted me with a smile every morning, wincing through the pain of fluid building up in her stomach from the cancer.
It is heartbreaking to see another human gradually dissolve into a shell of what they once were. As if she needed another hurdle to face, she was going through these complications without her husband by her side. Mr. S. was stuck in Texas, where they live, awaiting a heart transplant. My patient only happened to be in Baltimore visiting her son before she became acutely ill. It was a cruel twist of fate, something one would only expect in a movie script. But it wasn’t a movie, it was Ms. S.’s reality.
One of the hardest tasks during the first month of my intern year was to tell Mr. S. over FaceTime that it was unlikely his wife would be healthy enough to get on a plane and be with him. The truth took some time to sink in, but when it did, the silence in Ms. S.’s room was deafening. She was a religious woman, and as her husband was a pastor, he used the moment to say a prayer.
Eventually the pain was too much for Ms. S., and she accepted the fact that aggressive treatment was not going to get rid of her cancer. She wanted to be comfortable, and to spend her remaining days with peace, dignity and as much quality time with her family as she could. I held her hand as she made the decision to transition to hospice.
I often think about Ms. S., and what her days at the hospice facility are like. I hope they are filled with bright purples and pinks and blues, like those she used to decorate her classroom. I hope she spends hours on FaceTime talking to her husband, reminiscing about the life they cherished together. I hope she is listening to gospel music with her son. I hope she smiles to herself in the mirror when she sees how fashionable she looks with her silk purple bonnet. It was an honor and privilege to know Ms. S. for the short period of time that I did, and I hope she knows the impact she had on me and that I will hold our experience together close to me as I treat my future patients.
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