Holy Dove

Cristine
Mar 10, 2024
4 min read

Updated: Aug 4, 2024

I never thought I would wind up working on an oncology/palliative care unit. Let alone, I never imagined myself actually enjoying my time there. Despite spending two years of my career surrounded by cancer and comfort care, it is one of those departments that filled me up with life.

I know it sounds eerie to say, but bear with me. There is much enlightenment in a place of deep vulnerability ...

I remember encountering Mr. P. for the first time. He was a man in his sixties that had come in from the emergency department for night sweats, fever and unintentional weight loss. These symptoms are the classic "B-symptoms". To anyone working in oncology, this triad led to a high suspicion of cancer. Particularly, he was admitted in order to investigate what the hematologist would then confirm was Non-Hodgkin Lymphoma (NHL).

Mr. P. was one of those patients who looked too healthy to be roaming the corridors of a hospital. He was not confused nor did he require much assistance with daily activities. He would walk around the halls and say hi to the nurses and doctors at the nursing station. You would see him wheeling along his IV pole as he did so. So why was Mr. P. in hospital if he was mostly independent?

The NHL that he had was categorized as "aggressive" or "fast-growing". With that being said, as soon as his diagnosis was confirmed, he was to start chemotherapy without delay. Given the harsh nature of his ailment, an aggressive regimen was required to fight it off. One thing to keep in mind with chemotherapy is that it does not differentiate healthy and diseased cells; it kills all. When large amounts of cells in our bodies die, it can put us at risk for Tumor Lysis Syndrome (TLS). What the heck is that Cristine? Why do you keep throwing complicated words at us?

Well, to put it simply, TLS can cause extreme electrolyte imbalances such as too much potassium, too much phosphate, too much uric acid and too little calcium. Like anything in life, our bodies require balance - equilibrium. Hence, in order to reduce the risk of TLS, Mr. P. was to be administered intense intravenous hydration along with other medications prior to starting his battle with NHL. That would explain his need for his "walking aid".

Throughout his stay on the unit, Mr. P. slowly opened up about who he was outside these old hospital walls. We spoke about health, relationships and family. Ultimately, he and I bonded over our love for music. He would tell me stories about being the guitarist in a popular rock band in the 80s. He told me which keywords to look up to find old videos of his band on Youtube. I would share with him my amateur guitar/singing covers on my phone. The very first video I had shown him was me playing "Hallelujah". As he listened, he told me he really liked this genre of music. He then encouraged me to keep playing.

After a few weeks of treatment, Mr. P. was discharged from hospital.

A couple of months later, during one of my shifts, we had received a call from Mr. P.'s sister. In our oncology unit, during clinic off-hours, patients known to us that required advice could call us at anytime. This was our telephone triage. Often, it would be cases of patients experiencing unpleasant side effects from chemo and teaching them on their management. Other times, it would be a situation in which hospitalization was strongly recommended. In this instance, it was unfortunately, the latter option.

Mr. P. came back to our unit after re-experiencing B-symptoms and extreme fatigue. His lymphoma was progressing quickly, and it showed. He was immediately started on a new regimen, one that entailed more risks than the previous one. He stayed mostly in his room and was visibly out of breath sitting up at the edge of his bed for meals. This time around, the nurses, including I, would pop into his room to say hi. At the end of my evening shift, I went to visit him. I greeted him with a smile and so did he. As we updated each other on our lives, I could see tiredness and fear of the unknown in his eyes. I tried to keep the conversation jovial. I had offered to bring my guitar to work on my next shift for him to play. "That's really nice", he said. "However, with chemo and all, my fingers have become very sensitive." This is called chemotherapy-induced peripheral neuropathy. "I'll play for you then", I stated, knowing my skills were probably sub-par to his.

Once I got home, I whipped my guitar out and started practicing until my fingers became numb. Two days later, I brought my guitar with me to work. I was looking forward to playing for Mr. P. As I got off the elevators and onto the unit, I greeted my colleagues. One of my coworkers who had been made aware of my plans saw the instrument I had been carrying on my back, nodded and looked down. Her body language conveyed bad news.

"He's in ICU" ...

I never got the chance to see Mr. P. again.

Mr. P. stayed a couple of days in ICU. He was quickly deteriorating.

His final wish was this: to take his last breath on our unit. And he did.