INTERSECTIONS

PART 5

No, I Didn’t Have Favorites, but . . .

Coiffing Grandma

Chemotherapy presents a host of serious physical challenges, but for many people, fear of hair loss is the first reaction when they hear they need chemo. It’s easy to think hair loss is a minor concern when facing a life-threatening situation, but it is an emotional and physical mountain to climb for almost everyone. Before minimizing someone’s concern about hair, consider that shampoo alone is about a 90-billion-dollar a year business. Imagine the market for conditioners, gels, dyes, doodads, and styling. Hair is important in our society, with or without a serious disease. No one wants to look like a “cancer patient” or endure stares and questions. Of course, hair loss can represent a host of other losses associated with cancer and chemotherapy as well.

We took care of a big, strong Iowa farm woman. She was, as K.D. Lang sang, a big-boned girl with a big laugh. She wrangled kids, grand kids, hogs, combines,  ditch witches, and her husband. She would not be brought to her knees easily. Mrs. Miller underwent multiple rounds of chemotherapy over about ten years. After each round, she returned to the farm, resumed her hard work, and regrew a full head of hair. We wouldn't see her until her disease recurred.

We got the call from the clinic that Mrs. Miller was on her way over to our unit to start another round of chemo. When she got off the elevator, everyone froze in place. She walked up to the counter, but we could not speak. The only reasonable reaction to her hairdo was being speechless. She had hair, but it was, shall we say, periodic. Imagine one of those chia pets if a relentless cat chewed on it. There were tufts, some long, some short. She hadn’t had chemo in a few years so we were stumped. Had her oven exploded? Had she gotten involved with the wrong end of a weed trimmer? She looked at our faces and laughed.

“Well, I knew I was going to lose my hair again so when the grand kids asked to give me a haircut yesterday, I let them have at it. All of them. Some of their toy scissors weren’t too sharp.” We all began laughing along with this bighearted, indomitable woman. All but one of us, that is.  A young resident sat at the desk with something akin to horror spreading across her face. She looked pale, about to faint. Why would a bad haircut, even such an astonishing haircut, make an oncologist so sad? So stricken?

“Mrs. Miller,” she said, then hesitated.

“Yes, Doc?” Mrs. Miller answered.

“Your chemo? It’s a new kind. It–actually, it doesn’t cause hair loss.”

We all spun back around to Mrs. Miller. And, what did she do? She did exactly what you’d expect such a soul to do. She laughed her head off. She roared. She slapped the desk. I figured she wouldn’t be running for fair queen that summer.

How fortunate were we to cross paths with people like this? If I find myself in this situation, I plan on raising a fair ruckus. Then, I hope I also can muster a little Mrs. Miller. Such people teach us how to live.

Meeting the Legends

“Frugality includes all other virtues.”  

                                   Cicero

My husband used to tell of a fellow grad student who was famous for his frugality. If Cicero was right, this man was downright godly. When it was his turn to buy a round, he suddenly remembered he had to be somewhere. In four years, no one caught him picking up a check. Despite a long and distinguished academic career, it was his gift for protecting assets for which he was best known. ‘Twas legendary. I had never met this person but enjoyed hearing the stories when his former grad school buddies got together. This kind of behavior was well out of my wheelhouse. I come from a family in which arms have been lost fighting for the check. People arrange days in advance to make sure they get the bill at a restaurant; that is not hyperbole.

One day, this fellow called and said he and his wife were coming to visit. They asked if they could stay at our house. Of course, they could. After all, he was an old college buddy of my husband’s, and I wanted to meet the star of so many tales. I assumed he had outgrown his reputation since he was very successful and quite well off.

The couple arrived on schedule. They were serious sorts, very nice, but perhaps best suited to being extras at a movie funeral. Professional mourners. Sober in the midst of gaiety. Not given to fits of laughter. Well contained. Escapees from a Grant Wood painting. Dour, and not just any dour, but dour as the Scots say it, to rhyme with sewer.

The woman wanted to go to some auctions, but she didn’t want to put miles on her rental car. So, I spent a long day driving her around the Amish countryside, going from auction to auction. At the last one, she wanted to buy some blue canning jars but the lots were too big. “Could we bid together and then split them?” Thus, we became proud owners of enough blue jars to accommodate all the pickles and half the beets in Iowa. Back home, recovering from the heat and driving, I looked out the window and saw this woman lining up the jars in the driveway. She then cherry-picked about 20 of them, leaving me a terrific collection of cracked, chipped, and outright dangerous vessels. I put them in the garage and snickered a little. Later, a dear friend of theirs joined us for dinner and saw the jars. She said she’d like to have just one. Our guest went to the garage, produced one of my compromised jars, and sold it to her long-time friend for $5. We had paid $15 for about 50 of them.

Near the end of their visit, we held a party so this couple could see all their friends without traipsing all over town. The woman suggested she’d like to contribute something to the party since we had hosted them all week. She chose a fancy English trifle dessert. She spent the afternoon building it, using ingredients I had on hand. She found nearly everything she needed in our cupboards and fridge –the flour, eggs, cream, jam, sugar, vanilla, almonds–but was saddened to learn we had no strawberries on hand. Off she went to the store and returned with a big bag of frozen berries. And then, what did my thrifty guest do? She  gave me the bill so I could reimburse her. It’s always good when you meet a legend who does not disappoint.  

Finally, their visit was drawing to an end. “Let us take you out to dinner to thank you for your hospitality,” they said. Off we went, our guests, our family of five, and a child visiting our oldest son. They chose a pizza place. We enjoyed a nice dinner, and then I saw the check being transported across the dining room on its little tray. It was like seeing the Magna Carta approach our table. I was about to see an historical event­: they were picking up a check! They perused the pizza bill, then promptly prorated it. We were told our share would be 1/8^th of bill and 1/8^th of the tip; after all, our son had brought a guest. Turned out to be more of an hysterical event.

We had several more visits over the years; I can assure you that first one was not an aberration. These actually were very kind and decent folks. My guess is if you needed a kidney, they’d happily give you one. Plus, over the years, they have provided many entertaining stories and belly laughs for many people. And, isn’t it a mercy to the world that they found one another? Truly, how often do you get to meet the stuff of legends?

INTERSECTIONS

PART 4

No, I Didn’t Have Favorites, but . . .

The need for hospice care knows no boundaries. We cared for families of every description and in every situation. They lived in mansions and in cars. They were Father Knows Best and Maury Povitch’s Worst. They were quietly accepting and railing loudly. One day, I was called by a physician, who was referring his patient to hospice. His final comment was, “And good luck to you guys!” This physician was an experienced oncologist who had referred many, many patients but had never said anything like that before. His comment gave me pause.

The patient’s wife let me in. She looked exhausted. From the entryway, one could see through the dining room into the living room. It was like looking at a stage with a living room set and a play in progress. There was a hospital bed positioned in a bay window, a very thin middle-aged man in bed with pumps and IV poles nearby. He was gesturing wildly, yelling, swearing, and tossing the sheets about. Two men, his best friends, stood by the bed trying to talk to him. “Good luck to you guys,” indeed.

Greg was reacting to his dire situation in a completely understandable way. I have no idea why this isn’t more common, but in fact it isn’t. Some people have occasional angry episodes, but Greg was on a tear day and night from all reports. He was furious with his doc for “giving up on me.” He had made quite the scene in the hospital and not just when he was told that his treatments were not working. He had been taking on the entire health care team from receptionists to physicians since his diagnosis. His family and friends were completely spent, saturated with his anger and tantrums. You can imagine how Greg felt about meeting a hospice nurse.

Greg had a feeding pump unlike any I had encountered. There are so many kinds of pumps. We just learn to figure one out, and then they come out with a new one. As I made a few attempts to change the bag on this pump, Greg honed in on me like a sharp-shinned hawk on a limping mouse. He took me out. He questioned my ability to do anything. His friends attempted to calm him. I worked to become calmer as he revved up his fury. Inside, I went all Cuisinart, but I didn’t let it show.
When I walked into the social workers’ office, they looked at my face and raised all six of their eyebrows. This was one case I was happy to hand to them and to our chaplain. Another nurse would be Greg’s primary nurse. They all were in for a ride.  

Over the months, the social workers and chaplain performed a miracle with Greg; not on Greg, but with him. He did his work with their expert guidance and patience. In my twenty years as a nurse, I had never seen such a transformation. He became a calm, accepting, grateful man. His family was thankful to the point of tears. What this team did will affect Greg’s wife and children and his friends forever.

After Greg’s death, I received a note from his referring physician, a man was exceptionally dedicated to his patients, but he was not easy to work with. He was patient with his patients but reserved a difficult side for his colleagues, including us. Almost every call from him was a complaint. He was one of those people who could give a compliment and somehow tag on a little dig at the end. But this note. This note. It is one I kept taped on the back of my door for my entire tenure at hospice. “I want to thank each of you at hospice for what you did for Greg. I would not have believed it was possible. Nothing short of a miracle. What you do is important. Keep up the good work.” This doc went to see many of his patients at their homes, something unheard of in a major medical center. He had stopped to see Greg and received a heartfelt apology for past behavior and a completely unexpected expression of gratitude. Greg had bestowed a gift of peace on this  man that left him stunned and profoundly moved. It erased the angst their past encounters had buried in this physician’s chest.

Social workers and chaplains, I wish I could make each of you a superhero cape. Quiet little miracles take place every day at your hands, and this one was especially sweet.