Diagnosis: Small Bowel Obstruction
That was all I knew of the most influential patient in my nursing career, now and forever, that early day of my first year of nursing.
Ray was all of 140# when I met him. A gentle soul from the very first meeting. He was due for a CT scan in the morning to visualize the extent of his bowel obstruction. We chatted the night away as I kept him nausea and pain free, while letting him sleep off and on.
The next night when I came back we had bad news. Ray's bowel obstruction wasn't as simple as we had hoped. It was a tumor that had reappeared after five years in remission from colon cancer. When they went into surgery they discovered the worst. The tumor was large, and very low in the colon, making it nearly inoperable for our small rural hospital. Also it had metastasized all over his abdominal cavity.
Ray took the news surprisingly well. He was confident they would find a way. His wife sat by his side over the next month as we helped Ray get well enough to go home with home health. Our physicians pondered and ran diagnostics to attempt to find an answer, as I got closer and closer to this rural family.
I met all of Ray's children, and grandchildren (the youngest was about five). They would visit everyday and bring in balloons, while Ray got TPN/Lipids and antibiotics. He never lost his smile with them, even after they left. He was always pleasant, talkative and cheery, despite his potential terminal diagnosis.
Eventually Ray went home, however less than a month later he came back after an unsuccessful visit to the University Hospital. They weren't confident that they could do much to help him at this point, however Ray never lost his smile. Even as he lost 40# off of his slight build he kept his faith up. His wife was a beacon of strength for him, and helped every way she could, while managing their farm and business as well.
Ray and I got very close as I redressed fistulas on his abdomen as the cancer took him over. I held his hand as the doctor reinserted the chest tube between his emaciated ribs after a pneumothorax had occurred. I watched as this gentle man, would get out of bed, to teeter on legs nothing more than skin and bones. I witnessed the strength this man mustered through circumstances most others would shut down under.
One night Ray asked me in and we just talked. He told me how he did have some regrets. There were trips that he had wanted to take his wife on, and plans he wanted to see through for his children and grandchildren. I believe the loss of time with his grandchildren was his most significant regret. It was the first time I saw the anger and fear creep into his eyes. I quietly held his hand and reminded him of the wonderful life he had provided thus far for his family.
He died the next night. I was supposed to work, but had been called off. I still don't know if they called me off because after six months I had become so close to this patient, or if it was just coincidence. I never saw his family again.
When Ray came into my life I was at an odd impasse. I had recently graduated with my ADN-RN and had taken the first job that came along. I wound up forty minutes from all of my friends and life for the last five years, and two hours from any of my family. Basically in a "middle of nowhere", 10,000 population town.
I have always been a loner for the most part (I was an only child) and was pretty content in my little one bedroom apartment, three minutes from work. However I wasn't completely happy. I worked five 11p-7a shifts a week, was addicted to online gaming and was often on-call, leaving me with confused sleeping schedules and mild depression.
At this time I was befriended to a man named Jim. Jim was a man I had known for several years through an online game called World of Warcraft. He was a physics major from Houston, TX who came upon some hard times when his fiancee of a year and girlfriend of seven years forced him to move back home to Atlanta, GA after ending their relationship. Being the caretaker I am, I offered this long distance friend my ear, my phone number and my advice and we quickly became close and soon he came to Wisconsin to visit me.
Despite an instant connection, and amazing chemistry I quickly dismissed him as rebound, and offered him my friendship only. For about eight months I was nothing but support for him, until New Year's 2007. This day he admitted that he was comparing everyone he met to me. That there was no one else he thought of, despite some random dating. I had even taken the place of his long time girlfriend. After four hours on the phone he convinced me to come visit him in Atlanta. I hesitated but agreed.
Ray came into my life about a month later.
When March rolled around and it was time for me to visit, I was scared and hesitant. I will admit I am no good at long distance relationships and will never participate in another one again. I have a mish mash history of bad boyfriends, lame crushes and cheaters. Long distance doesn't mesh well with my trust issues, but something was different here. For one I was curious. Someone who took such time to pursue me deserved a chance, and at this point I was very involved with Ray's care. His fortitude and regret for things he had done left me questioning mortality and life itself.
So I hopped on a plane and flew to Atlanta, and met the family of the man I would later call my husband.
As Ray deteriorated, my life seemed to bloom and change. I mentioned earlier I am an only child, with a very close relationship to my mother. I mean like the best friend kind of relationship, the kind you don't take lightly. As my relationship became more and more complicated (Jim was flying to Wisconsin every month to see me) I realized that I had a very big decision to make. To leave my family, or to leave my love.
I looked to Ray for advice. I knew the sacrifices he had made for his family, and I saw how strong they were. How their love and compassion was helping them through this very solemn situation. How his children and wife stood by his side even as he got to the point where he couldn't get out of bed on his own.
I listened to his stories, reviewed and pondered his life and made the biggest move of my life.
I left one month after his death and never looked back.
My mother took the news much better than I thought she would, especially after hearing I had gotten an interview at my current workplace one minute and forty five seconds after I posted my resume to them. Even though we are several states apart, she respects my decision as one of the best I have ever made, and if it hadn't been for Rick and his courage, I may never have had the resolve to take this chance.
Happily married for over eight months to one of the kindest, most patient souls I know, I can't imagine life any other way. I think almost every day of Ray, and send my prayers to his wife and family left behind. I take comfort in knowing that they had such a strong connection, that they are surely living strong and well with Ray close by in their hearts.
Thanks for listening,
Last edit by Tait on Jul 10, '09