Monday, October 26, 2009

I lived in a different universe this weekend.

And it was really nice.

For a whole day and a half, I had nothing to do but eat good food, yammer at interesting people, and listen to Neko Case and Fountains of Wayne on the car stereo.

Meanwhile, the family of a patient I had last week was discussing whether or not to turn off the vent and make Grandma a DNR. Grandma is not going to wake up, sadly; she had one of those intracerebral hemorrhages best described as "devastating". Oh, and she infarcted both frontal lobes. And then, because she was stuck in a tiny hospital with no neurosurgeon or neurologist, she herniated just enough to screw up her brainstem. Apparently she'd had a headache for a day or so, but being a tough mother, she didn't say anything to anybody. Her husband found her facedown in the living room one morning last week.

I also did not have to live the life of one of my former patients, who's back. We took a metastatic melanoma out of his brain about a year ago, and he's gotten to the point where he needs Interleukin-II therapy. That's the last resort for people with Stage IV melanoma and kidney cancer. Without it, five-year survival is about two percent (for renal CA) to four percent (for metastatic melanoma). So he's in the unit for the first round of fourteen days of IL2, if he can tolerate it, and we'll all see what happens after that.

And, finally, I do not have to be an old friend of mine who's currently in the unit with a galloping case of GVHD (graft versus host disease: it's what happens when you get a bone marrow transplant and the transplant, with its new and marvelous immune cells, turns against your body) after a matched, unrelated-donor bone marrow graft. That was a shock: I walked onto the unit this morning to see his name on the board and stopped dead. He was a sponsor for my church's youth group when I was a teenager, and I went to school with all three of his kids.

Now he's in a bed, so badly screwed-up that we have a specialist in burns taking care of his skin, on a vent, with constant drips going to try to save his kidneys, his liver, his lungs--*any* part of him, really. His doctor considers it a hopeful sign that he only had three liters of diarrhea yesterday.

Tonight it's raining. It's chilly and foggy and misty, so Max and I will have a cuddle party on the floor of the living room after I dry him off. I'll go to bed early, and wake up early, and head to the grocery store at the time of day when the horizon is bleeding into the sky, so you can't tell where the trees end and the clouds start. Then I'll run for a while, and lift heavy things, and give thanks that I can do that and still have the wherewithal to start a big pot of bean soup.

I live in a different universe from a lot of people every day. Sometimes there's overlap; mostly there's not. Mostly I'm thankful there's not.


TorontoEmerg said...

Oy. Which is when you say, "There but for the grace of God go I" before realizing that in itself is a completely ambiguous statement.

I sometimes think we nurses are privileged, or cursed, to know the myriad ways our bodies will eventually betray and kill us. I am not sure I am happier with that knowledge, if only because we don't have the luxury of actually choosing what will carry us off to the Great Unknown. So I'm with you: cherish what you have now, and let the future take care of itself, because it surely will.

woolywoman said...

Any day I'm next to the bed and not in it is a good day. I try to remember that.

bobbie said...

Carpe Diem ~~~

Rat said...

oh, dear, it sounds like it's a good time to go have some alcohol and laugh at someone else's life. Namely mine. And for some reason for the past, oh, 22 years or so...our universes seemed to have overlapped, no matter how odd they are. I'm pretty sure that is a good thing on most days....some, I'm on the fence. This one may be one of those days. Alcohol does make it better. I am sure of that.