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Dying patient invigorated by children's visit

Monday January 28, 2013
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In all my years in oncology, I never had seen anything like this. Meredith was a 44-year-old mother of two young boys. Her health had been deteriorating since she was readmitted to our stem cell transplant unit.

She’d had an allogeneic transplant after suffering from non-Hodgkins lymphoma and was experiencing complications. Meredith often would tell me how frustrated she was about how weak she was feeling. She would tell me about how she needed to constantly be on the move. I’d had Meredith as my patient when she was still able to get up, walk, feed, clean and dress herself. Weeks later, she was unable to do any of those things.

She was getting dialysis for her kidneys, which were failing, and photopheresis for her liver daily. She could not get out of bed, and sadly she also was having a severe change in mental status. She could do nothing more than mumble incoherently. She often would begin screaming for no reason and had to be calmed with medication.

I vividly remember helping a co-worker try to give Meredith her medication. Meredith wasn’t one of my assigned patients that day, but I had missed her and wanted to spend some time with her. She simply could not swallow her pills. We placed each of them in a spoonful of applesauce, and she would somehow manage to get the applesauce down yet the pill still would be sitting on her tongue. We couldn’t make out a word she was trying to say because she was disoriented and her speech was garbled. Her eyes were practically swollen shut from scleral edema. The rest of her limbs were filled with fluid, making any kind of movement difficult.

As we continued to try to give Meredith her medications, I heard two little boys’ voices getting louder and louder as they ran down the hall toward her room. I knew at once these were Meredith’s sons, about whom she had talked so often. Meredith had told me how hard it was to conceive both of them, how she needed a donor’s eggs because of all the chemotherapy she had received. She also said what a miracle they were, adding, "When you want something bad enough, you don’t stop trying until you get it."

I recalled the very first day she was readmitted, being in the room when the doctor told her we weren’t able to discharge her yet. Her big blue eyes filled with tears as she stared down at a picture of her boys on her laptop and said, "I just want to get home to them."

On this day they came bounding into the room and ran to the bed, shouting "Mommy, Mommy, Mommy," jumping up and down because it probably had been about three weeks since they had seen her, trying to climb onto the bed to be close to her. That sight alone made my eyes immediately well up with tears, and as I was about to excuse myself from the room the most incredible thing I have ever seen happened. It was as if another person had temporarily invaded Meredith’s body. She reached her arms out to her boys, opened those poor swollen eyes and began speaking to them. The voices of her boys evoked something within this terribly sick woman that made her rally like I have never seen another patient rally before.

After that my floodgates opened, and I had to leave. The feelings were so intense, I went into the utility room and just allowed the tears to flow. Could it have been because I am a mother to a baby girl and I was thinking of her? Was it because I knew Meredith might never be home again with her boys to hug or kiss them? Or was it from witnessing a simple miracle of the human body, a mother who heard the voices of her children and gained a strength that allowed her briefly to be their mother again? Meredith died not long after that day, but in this moment her words made sense, she was speaking clearly and she was able to interact with her boys. I could see it was exhausting her, but she was not going to have it any other way.

While I cried, I thanked God to have the job I have. Although terribly sad at times, my job makes me grateful for my life and health every single moment of the day because you never know when it all may be taken away. I am so privileged that I am able to do what I do and witness such beauty and love and, yes, miracles. That day will be embedded in my memory forever.


Maria Tessinari, RN, OCN, is a staff nurse at Hackensack University Medical Center in Hackensack, N.J. Write to editor@nurse.com or post a comment below.