Originally Posted: 6/28/2011
Last week my Dad had an appointment for a post-stem cell transplant PET scan followed by an appointment with his oncologist. Unfortunately, I was unable to accompany him, as I had to work that night, but spent the day at home anxiously awaiting the results. When I finally was able to talk to him on my way in to work, I heard the news that we had been hoping for- the PET scan was clean, the transplant had worked, and he was in complete remission. Hallelujah! According to my Dad, his oncologist “did a jig” around the office when he opened the scan with my Dad and saw the results, and then promptly forwarded the results over to my friend “Dr. Doom and Gloom” over in the ICU. While a PET scan is not generally used in staging Multiple Myeloma, my Dad’s oncologist finds it useful to compare a pre and post transplant scan to determine if there is any Multiple Myeloma lurking around that is not detectable in the serum. If so, that is often an indication to do a tandem (or back to back) transplant. We had already decided that after what had happened the first time, a tandem was probably not in my Dad’s best interest. So needless to say, we were happy to get the PET scan results back and see that there was no indication for a tandem either way.
That evening at work, I was taking care of a 10-year-old who had had major abdominal surgery that day. He had several drains that needed to be emptied every hour, so I spent quite a bit of the night in his room. As I was working, I chatted with his mother, who told me that she too was in healthcare. When I asked her what she did, she told me she worked as a patient care technician on the same stem cell unit where my Dad had his transplant. I told her that my Dad had had a transplant back in February and just today he had gotten the news that he was in remission. She asked me his name and I told her, but she was not sure if it sounded familiar. However, she also said that she has stopped remembering patient’s by their names and just thought of them by their room number. “Too many young people that don’t survive,” she told me, “and I have noticed that I don’t even feel sad anymore when I hear that they have passed away.” She felt as thought she had stopped feeling and had become numb to grief.
She asked if I had a picture of my Dad, to see if she recognized him. I showed her a picture and her face lit up with a smile- “Yes, I remember him,” she told me, “He was always out walking in the hallway, and always had a smile on his face! He was in 589- but I heard what had happened to him and I wasn’t sure I wanted to know how things turned out.” She told me it made her day to know that he was doing well.
I realized how often we do this same thing on my unit. In the intensive care unit, we often don’t know what ultimately happens to our patients. Some become regulars, while others we never see again. Time will pass, and we will receive a death notice. Other times, I have run into patients that I knew from my pediatric hospice days 7 years ago that suddenly show up in my unit, much older now but often still very much the same. In the lunch room, we will ask each other- “How’s 20 doing?” “Did 5 go up today?” “Did 11 finally go home?” Or “Don’t you remember so and so? The kid that was in 15 forever.” It is easy to lose your identity, especially in the ICU. People just don’t look the same when they are intubated, paralyzed, and sedated. I always encourage parents to bring in pictures of their kids so I am able to get to know who they are, and we plastered the walls of my Dad’s room in the ICU with pictures of him hiking, swimming, hanging out at our Michigan home, and walking me down the aisle at our wedding, to remind people that he is more than just a number. But getting too close makes it impossible to do the work we do every day.
At the end of the night, the mother told me that she was sure she was meant to meet me that night. She had been considering leaving her job, but seeing the picture of my Dad now reminded her that some people do get better, and that she has the treasured opportunity of playing a role in that process. “We see people at their worst,” she told me, “But I am glad to know that what we do on transplant allows some people to really live life at their best again.”