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.
“Med/Surg, this is Autumn,” I rattled off as I picked up the receiver. I was working as a nursing assistant at the only hospital in a small Midwestern town. It was early in the night shift, around 7 pm.
“Hello, I heard Cynthia Doe is at your hospital. She’s my very best friend. Can I talk to her?”
“Sure. Can I put you on a brief hold while I check with the nurse?”
I found Cynthia’s nurse and checked if I was allowed to send the call into her room. Cynthia had been to our unit a few times before. The first time I met her, she had massive lymphedema in her legs. Her swollen calves were nearly a foot across, and she could barely walk as I helped her to the bathroom. The last time I saw her, her calves had shrunk to half that size.
“Look at me now!” she said. She had started a new medication and felt like she was getting her life back.
When I walked into Cynthia’s room to answer the phone for her, I was startled to find that she was on hospice care and barely responsive. Nonetheless, I held the phone close to her ear, and I let her friend talk to her for a bit. Cynthia couldn’t speak, but I hoped she could hear. Afterward, I told her friend that we would be happy to let her visit, even though it was after hours.
“Oh, that’s OK, I’ll come see her first thing tomorrow,” the friend replied.
Around 6 a.m. the next morning, as I was getting ready to head home, I overheard Cynthia’s nurse calling someone on the phone to report her passing.
Some of my hospice patients had died during my shift before, but I hadn’t known any of them before they went on hospice. I hadn’t answered a call from someone calling them their “very best friend.” I wept on my drive home. I couldn’t help but wonder whether Cynthia’s friend was disappointed that she had just barely missed her chance to see her one last time.
It’s been two years since then, and a lot has changed. I left my job to join the M.D./Ph.D. program at Johns Hopkins. Yet in many ways, the experience of caring for patients is the same. As a second-year medical student, I go to a primary care clinic every Tuesday afternoon as part of my Longitudinal Ambulatory Clerkship. A few weeks ago, I had my second visit with Janice, whose heart is just barely managing to function with a continuous medication dripping into her veins. She knows she will need hospice soon. At the mention of hospice, my thoughts wander back to Cynthia and her friend. I hope that there is someone who calls Janice their very best friend, and that they get their opportunity to laugh and cry and embrace each other one last time. I hope we all do. There is only so much time.
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