The Story: Calming the Storm
Kristina Newport MD Hospice & Community Care
I’m awakened by a 5:30am text from my medical director: the inpatient unit may need to evacuate due to water damage. Please go there as soon as you can.
Upon arrival, the front hall of our typically peaceful inpatient unit is filled with firefighters. They responded to the fire bells that went off at 4am, when a pipe exploded, flooding the front hall, workroom and 2nd wing of our three wing unit.
I headed into the room of a 38 year old woman who I will call Natalie. She had come in the night before for imminent death. She had a 4 year history of breast cancer that now had spread to the brain causing increased intracranial pressure and herniation despite whole brain radiation therapy, Mannitol and steroids.
Her mother met me at the door of the dark room, angry and anxious. Disappointed that she had agreed to bring her daughter to this place that promised a peaceful death. Instead she found chaos and a threat of evacuation on one of the coldest days Lancaster counties has seen in decades.
I knelt on the floor beside the couch where the mother had spent the night. That’s when the story unfolded. She began with the initial diagnosis and the need for neoadjuvant therapy to shrink the tumor before it could be resected. Then the chemo. Then radiation. The emergent intubation when ‘we almost lost her’.
The year of remission.
And the time when, a year ago, Natalie got short of breath and was found to have multiple metastases in her lungs. She faced a decision of whether or not to pursue palliative treatment. Natalie said there was no question because her children, who were 3 and 6 years old. She wanted as much time as possible with them, so that they “would remember her”.
Despite illness and debility, she spent the following year getting q 3week chemotherapy treatments and making those valuable memories with her children. She volunteered in her their classrooms and took them on outings every chance she got.
One week before she died, she lost her vision and her ability to walk. She insisted, though, that she accompany the family to her older son’s basketball practice. She sat in the bleachers, smiling persistently. Her mother asked her, why are you smiling like that? She said, “I can’t see whether he is looking at me or not, so I’ll just keep smiling. That way when he looks at me he knows I’m happy to be here with him.” That would be her last basketball game. And she knew it.
On the night before she left home, her oldest son seemed to sense her decline. He lay down in bed with his grandmother and said “I just don’t want to be alone tonight”.
As our hour together progressed, the sun slowly rose outside the patio doors, with white light reflecting off the snow onto the mother’s tear lined face. While firemen, electricians, plumbers, CEOs, insurance adjusters and hospice staff swirled around the halls, Natalie’s mother quietly finished the story. Telling me that her daughter was the most amazing mother, and person, she had ever known, but that Natalie was finished. And she knew it. Natalie gracefully instructed family to ‘Let me go”, and asked her brother to come care for the boys.
While we talked, Natalie lay, quietly, in a comfortable bed with quiet respirations. Her mother quietly showered her love and respect over the whole room. Somehow, by the time I walked over to examine Natalie, the room was warmer, and brighter and calmer. Although no medications were administered, and I had spoken very few words.
The story had created a shared blanket of warmth and calm that covered all three of us. Sometimes I forget the power of the story.