The Patients Who Break Your Heart

From the earliest days of nursing school, when we were taught never to become "too involved" with our patients, we nurses find ourselves balancing precariously on the gossamer thread that separates caring for people and caring about them. Being only human, of course, we sometimes cross the line despite our best efforts........and the nurse whose restless dreams are unpopulated by the ghosts of past patients must surely be a rare bird indeed.

I'll never forget:

.........The 29-year-old mother of four who was dying of cervical cancer. Cervical cancer! How many such ailments are both so easily cured, and so tragic when not caught in time? I cared for her during only a single shift, but something still haunts me about the way her mother sat for hours smoothing her long black hair across the pillow, and the quiet dignity that never allowed one word of complaint, even as the bitter pain of the disease and the heartache of her husband's deportation to Mexico at a time when she needed him most gnawed at her.

Meanwhile, the children played quietly about the room as I performed the tasks which must be done; they seemed to know, somehow, that this was a solemn time, and yet they were polite and curious about what I was doing for their mother. I heard a few days later that she had passed on only a few hours after my shift ended; and my heart cried out angrily for an explanation which has never materialized, even to this day. I think maybe I am not meant to know......only to accept.

...........The elderly but still vibrant gentleman who had just been diagnosed with Stage III esophageal cancer and given an estimated six months to live. On the second evening after his diagnosis, he asked my advice on chemotherapy, radiation, and other matters; his mood was genial, and he seemed satisfied after I had presented him with several different options. At that point, he called his family together in his hospital room and talked with them for over two hours, after which discussion he put on his call light and asked me to walk with him around the floor for a short time. This I did gladly, as he was a very pleasant man and I enjoyed talking with him. Then he stopped me short with this six-word sentence: "I'm going to end my life".

Of course, words of caution immediately sprang to mind---"You mustn't think like that", "Don't give up hope, there are still things they can do for you"---but died on my lips as I looked into his earnest eyes. This man meant what he said, and no psych consult, antidepressant drugs, or pleadings would stop him. I knew that as well as I knew my own name. Still, I begged him to reconsider, citing the devastation his suicide would surely wreak on his family and friends. Finally, he said, "All right, I'll think about it.........for your sake." I was so happy that he'd decided to hold off on harming himself, I hugged him right there in the hallway, and when I discharged him home the following evening, he reassured me that he would still 'think about it' before coming to any decision.

The next day---or so the local newspaper said---this dignified, self-determined man walked out into his garage and shot himself in the head. And I've never told anyone about the conversation we had that night in the hospital.........until now.

These are the patients who break my heart. Who is yours?