A No Good, Very Bad Day

Yesterday started like most days, an irritating drive in to work, a long list of patients, irritable doctors, and a very tired me. Mike and I had talked late into the night, about nothing at all but neither wanted to hang up the phone until exhaustion took over for both of us.

As I pulled up my hospital list, a name jumped out at me. A young patient that I have followed in the outpatient setting had been admitted to the Intensive Care Unit. She had seen us for a benign lung nodule but had a long history of breast cancer and had been struggling of late with multiple health issues. The last time I saw her, she seemed to have plateaued and was beginning to find her way with the new infirmities. But now, here she was.

It became clear, quickly, once I saw her and reveiewed the chart that my friend was not long for this world. The cancer treatments had erroded her bowel and her body was falling apart from the inside out. She was quickly failing and no matter the intervention, her blood pressure remained in the toilet and she was requiring a machine to breathe. Her loving family surrounded her bedside. Discussions of surgery danced in the air but it was clear what the outcome would be regardless of the intervention. As I sat down with her family to discuss what would be our recommendations, my heart broke. This patient and I have had a connection because of similiar ages and angsts; but also because of her placement in her family of 8. She is the youngest of the three girls and her family makeup is the same as mine with the oldest a boy followed by three girls and then two younger boys. And now, I was recommending the withdrawl of life support and the addition of morphine to make her comfortable. At the family's request, I was at the bedside as she passed away and for the first time in 17 years, said the rosary.

I went back to the office and put my head down on the desk and cried. And later in the morning when Mike instant messaged me, I told him about my morning. He was good, he didn't ignore the uncomfortableness of the situation. Instead, he asked about my patient and her family and me. When I saw him last night, he said nothing about it but wrapped me in those big arms of his and held me as I became ugly, sniveling, snotty, and blotchy doing the ugly cry...

So it was a no good, very bad day that might have made me move to Australia that turned into a wonderful evening of discovering that this wonderful man is as mad about me as I am about him. And once again, it was 1:30 am as I was heading to bed because neither one of us wanted to acknowledge the time that would make Mike head home. I am exhausted today but for some reason I can't erase this Cheshire Cat grin from my face...