Standing Ground

“One day, I’ll walk.

Watch me, you’ll see.

We’ll have a talk

Over a cup of coffee”

You had a fighting spirit, 

Unlimited hope

One hard to compete with. 

To pessimism, you said nope. 

You had patience 

One of a kind

Master of resilience

In the most difficult of times 

Farewell my friend 

You fought a good fight 

Brave ‘til the end 

Get some good rest tonight 

04.06.20

---

Mr. D. was a Portuguese man in his forties who was diagnosed with gastric cancer. He was a wonderful family man whom was easy to get along with. He would always talk about his wife and his son, of which I later found out was his stepson. The way he described his relationship with him was as if he was his own, and that is what I greatly admired of him. He was the definition of a true man; one that displayed strength, resilience and kindness to everyone.

When Mr. D. was first admitted, he would walk in the corridors with his own two feet. However, as the tumor progressed, and spread to different regions of his body, his body's abilities started to differ greatly. As the cancer started invading regions of his spinal cord, Mr. D. required a walker. His legs would not move as he would want them but his determination to getting back up to his feet was evident. As he passed me by in the hallway with the physiotherapist, he paused for a minute to talk to me and my colleague. "Just watch me girls, one day, I'll walk out of here and we'll grab a cup of coffee all together."

It was hard not to believe him. And so each passing day, the whole medical team was rooting for his recovery. Things did get better ... until they weren't.

As the weeks went by, Mr. D. began to lose the ability to move his legs. This sudden paralysis was devastating. He would always put on a brave face, but we all knew he was suffering. As he winced while changing his position in bed, he appeared fragile. Not turning him however, would do him no good. He would require the use of a lift in order to transfer him to a chair, or simply remain in bed watching out the window. Positioning him comfortably was difficult and required a tremendous amount of patience. As he frowned and grunted, staff would apologize. He would always say it wasn't our fault, and was full of gratitude when painkillers would be administered.

Later on, Mr. D. started displaying crossed eyes. He would complain of his double and thus, an eye patch was given to him. A scan of his head showed that he had brain metastases. Thankfully, his cognitive status remained intact. Mr. D. continued to fight the battle against his body. With supportive family members alongside him, he was content on the daily.

---

Side note: This story occurred during the COVID-19 pandemic. As not much information was known about this disease, its spread was at its peak, enforcing governments to impose restrictions.

---

On March 14, 2020, the Health Minister announced that unessential visits to hospitals (excluding palliative patients) was prohibited effective immediately. I remember hearing about the news on my evening shift and having to ask family members in each patient's room to leave the premises. It was heartbreaking, and terrifying. Mr. D. kept in touch with his family via video calls.

As COVID cases in hospitals grew rampantly, a designated surgical unit was turned into a COVID unit in attempts to lessen its spread. Nurses from different departments were relocated in order to get the department going. Unfortunately, once COVID hits an oncology unit, the consequences are fatal. When we talk about cancer patients, the diseases themselves or the treatments given weaken the immune system to a potential fatal level, thus requiring protective external factors (isolation, strict hand hygiene, medication to increase white blood cells, etc.).

Two weeks after the announcement, Mr. D. began presenting with fever, a cough, and low oxygen saturation levels. He required 100% non-rebreather mask to maintain them at acceptable levels. Mr. D. was transferred to a private room to prevent other patients from contracting it. The now infamous nasopharyngeal swab was done on him, and in a matter of hours, his results came back. Positive. He required an admission to the COVID unit. The task of transferring him to another floor was difficult: we were not permitted to use the non-rebreather mask outside in the halls for fear that his droplets may contaminate others. As per the hospital rules at the time, the maximum amount of oxygen that can be delivered during transfers was 4L/min through nasal prongs or a face mask. Additionally, security had to be made aware of any transfer of a COVID positive patient in order to maximize its coordination and speed (they had to give us special access to the elevators). When porters arrived, geared up in all the PPE (personal protective equipment), security was notified and Mr. D. was switch to a face mask for a few minutes.

An hour and a half later, we receive the news that Mr. D. had given his last breath, isolated and without family around.

Mr. D., I hope you are looking over us with your cup of coffee in hand. Your memory will always live on to the lives you've touched. May you rest in peace.