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A quiet way of dealing

Oncology RN touched by patient's grace, dignity

Monday October 14, 2013
Sarah Cutrufello, RN
Sarah Cutrufello, RN
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As an oncology nurse, I witness how ordinary people living with cancer cope with their extraordinary disease; how common people summon the uncommon strength to receive the toxic cocktail of chemicals that medical professionals call “treatment.” Each case is different, each patient unique.

About two years ago, I was fortunate to develop a relationship with a woman who had a special way — quiet, gentle, dignified — of handling her disease. At 66, she had been diagnosed with acute myelogenous leukemia.

When we first met, she looked up at me from her hospital bed and solemnly said, “I should be in Switzerland today … .” Her husband finished the thought — they had booked a week-long trip to Germany and Switzerland. Recently retired, the couple had reserved a place in their minds for that special spot to drink tall glasses of wine in a cabin overlooking the Alps.

Yet here they were, in a hospital room in Philadelphia. Their updated itinerary consisted of eating tasteless scrambled eggs and lying on an uncomfortable mattress overlooking the brick buildings of the hospital’s sprawling city complex. It was not fair.

In that moment of our first meeting, I felt a profound sadness. This woman had an exciting life that she shared with her husband, who one could instantly tell was head over heels for his wife. Cancer was robbing her of this life.

She never said she was scared or upset or angry. She was appreciative of everything I did. When the physician’s team came in, she fooled them with her sweet smile and upbeat attitude. It almost was worthy of some kind of perverse Oscar award for “Best Performance in a Terminally Ill Role.”

But I could see through the act to the deep pain and hurt of the “actress” lying in bed; someone who was struggling to come to terms with the fact that as recently as a month prior she was enjoying a vibrant life with her husband and friends back home.

A few weeks later, on St. Patrick’s Day, she could barely wait to tell me as I walked in, “I should be at a great party today.”

“A great party? Tell me about this party,” I said.

Her face lit up as she told me how her neighborhood opened its homes on St. Patrick’s Day to hold a sort of bar crawl. Again, though, there was the hint of disappointment.

I listened with a smile on my face and said — as I always said when we talked about events she could no longer attend — “When you get out of here, you will do these things. I promise.” These words felt like equal parts truth, lies and hope mixed together in some kind of phrase that needs to be said on such occasions.

Later, as I was unhooking her blood transfusion, I noticed she had found a few moments to sleep. I stood there for a moment, silently, my eyes filling with tears. It occurred to me just how disappointed she must have been every time she woke up and was confronted with the reality that is cancer.

She was not in Switzerland or Germany or enjoying a great St. Patrick’s Day party with friends. The life she had known before cancer stopped her in her tracks was happening someplace far removed from where she was. She would die about a year and a half after I met her.

Above all else, this experience taught me the importance of approaching patients with open ears and an open heart. Dealing with anxiety, anticipation, fear, loneliness, uncertainty or any number of other emotions, our patients often need a kind of nursing care that goes beyond administering their prescribed treatment.

At the close of that day’s shift, I said to another clinician, “I feel her sadness. She breaks my heart.” To which the other person gave a quick chuckle and said, “She’s not sad.”

I thought to myself: another Oscar-worthy performance.


Sarah Cutrufello, RN, MSN, OCN, is a hospital oncology nurse in Philadelphia. Send comments to editor@nurse.com or post comments below.