Kari Stiles relates a patient interaction while caring for a woman who was close to dying and how she handled her with love and compassion.
“My whole life I never needed a doctor. Never sick. Never broke a bone. Never hospitalized. Nothing.”
As a nurse, this isn’t an uncommon thing for patients to say. Many times it’s a simple case of denial and fear, but in this case she wasn’t wrong, exactly.
This was how my patient greeted me as I entered her room to begin working with her. This brought out my initial gut instinct that she was like an iceberg—a modest, noticeable piece on top and a bottomless, indefinable, fluctuating force underneath.
Tina and I began sharing the usual small talk while I was examining her—her favorite restaurants, what food she wished she could eat, the names of her kids and grandkids, where she got her pedicure done—and then she looked at her hands and she said, “I don’t have long, do I?”
Prior to meeting Tina, I read the specialist’s consults, multiple scans, blood work, saw the palliative care consultant’s signature, received a thorough shift report from the off-going nurse, and I now had my own assessment to add, my perspective on her status.
I remained silent, sat down, and held her hand. We made eye contact and she started crying.
“I don’t understand this. I never did anything wrong to anyone. I went to work everyday. I took care of my kids and my parents, never even got a speeding ticket. What did I do to deserve this? I must’ve done something wrong for this to be happening to me!”
She continued to cry and process out loud while I hugged her tight and gently rocked her. I remained silent. I had no words for her. I don’t know the real answer to her question.
Medicine allows us to make generalizations and our best guesses. We are able to provide information based on averages and historical data but the timing of death isn’t like an egg timer, nor would I want it to be.
But I did know that based on all the findings the truest answer to “I don’t have long, do I?” was, Yes, and there may not be much time.
I didn’t say those words. I didn’t need to say it. I think she just needed to feel like a human being, like she wasn’t just a patient, just a thing to roll around to all types of advanced testing, just a green, three-ring notebook. Tina needed someone to stop what they were doing long enough for the iceberg inside her to safely breach the surface with its full force and show itself, show her truth, her magnitude, all of her pain and uncertainty. She just needed someone and I’m glad it was me.
As I held Tina, I looked at the photos someone had taped to her wall—a picture of her grandchildren from last Christmas, wedding photos of her daughters, an adorable dog in a photo with a younger, healthier, vibrant Tina. This is her truth—these loved ones, this life she built to success, the smiles on all their faces. This is what matters.
She was able to settle and apologized profusely for “falling apart.” I told her, as many nurses tell their patients, “Thank you for trusting me with such a vulnerable moment.” It truly is amazing the trust our patients give to us, it’s like few other careers.
After medicating Tina, I made arrangements with my favorite CNA, a true angel, to give her a nice warm bath before bed while I continued to care for my other patients.
I returned to Tina’s room once I was finished to find the energy in the room much more calm, the lingering thickness in the air from the cream used on her fragile skin, the faint condensation on the windows. Tina appeared genuinely relaxed.
“Thank you,” she said. “I’m okay now. I’m going to be okay. They are going to be okay, too,” as she gestured to her photos. She gazed at each of the faces in those photos and said again, “It’s all going to be okay.”