It was hard not to notice him. Amidst crying babies with RSV and cachectic young kids with terminal conditions, he looked extremely out of place. He was wearing a plaid bathrobe and leaning against the nurses’ station counter joking with one of the nurses. I heard him ask if she could let him into the PT room so he could lift weights. At 6’2″, he looked like someone who worked out routinely and as a consequence fought off female admirers constantly. He looked much older than his 17 years. In fact, if it weren’t for the IV pole he pushed around, there was no reason to believe he was here for chemotherapy.
Newcomers got the brief introduction so they would not feel excluded: “He was diagnosed with ALL eight months ago. His doctors say cases like his do poorly.” The nurses would then reminisce about how he helped out with last year’s Christmas party for the kids. According to them, many of the younger cancer patients would ask for him when they returned for their treatment. I noticed the duties that were usually done mechanically or with a grumble were done wholeheartedly whenever it involved him. The entire floor was transformed by his presence.
His room was crowded with family members, balloons, and flowers. From behind his closed door it sounded like a party was always going on. After the commotion was over each day, the nurses would nudge each otehr when the sister of another patient who had developed a crush on him would slip into his room instead of visiting her sister.
His chemotherapy started on Tuesday. He was confined to his room as if he were grounded. The Heme/Onc attendings treasured him to the point that only the senior resident could examine him daily if they were not available. While everyone seemed to have a personal connection to him, to me he was the patient behind the door that read “Neutropenic Precautions.” Sometimes I saw the foot of his bed as the door swung closed. I felt like I was the only one who was a stranger to him.
Later that week after a busy call night, the resident looked at me apologetically and said, “Could you draw some blood from Corey? We need some more, and I need to admit this patient.” This was my chance to become his best friend – everyone else had a head start. What would I say? How do I introduce myself?
I burst into his room partly out of eagerness and anxiety and stopped short at what I saw. He was in the fetal position. At the sound of my entering, he raised heavy lids and then closed them. His lips were so ulcerated I couldn’t see where they began, and most of his hair was on his pillow. I lost all sense of what I had planned to say and stammered something stupid about how I knew he had been through a lot. I wasn’t sure if he was even listening to me. I felt completely inadequate and incapable of providing words of comfort. With this magnitude of suffering, I was afraid that I would sound trite.
I decided to focus on the blood draw. His muscular arms were heavy and limp as I positioned them. He had IVs in both arms and his hands were bruised from repeated sticks. When my first stick failed, I began to panic from the thought of being the cause of more pain. Panic became frustration as his veins collapsed one after another. He deserved better than this. He had every right to be angry about many things.
At that moment, his hands moved out from under the sheet and pointed to a vein on teh side of the hand I was holding. “This is a good one,” he mumbled from his bleeding raw lips. He smiled, as if to say, “It’s OK.”