I Wonder If?
Submitted by Stephen O'Hare
It is the second Thursday already. The last two weeks went fast. All the two weeks seem to go fast lately. In any case, it is chemo day, not the most favored day on my calendar. I should be getting used to the routine every two weeks by now, Tuesday I go for my blood draw. The lab sends an analysis of the blood they take to Doctor D. It is one of the factors he uses to determine the amount and type of chemotherapy they are going to infuse into me, a seventy nine years old man with a heart problem and on my third case of cancer. Chemotherapy is simply a very strong anti-biotic designed to kill cancer. There are over one hundred different types of chemo for the different types of cancer. No one type does it all. Chemo, as it is also referred to, will kill the cancer, but it will also attack other parts of the body, such as the nervous system in your hands and feet where you feel a constant numbness with flashes of pain. They call this side effect neuropathy. It starts very small but grows gradually with each chemo treatment.
Neuropathy is the reason I am not driving to the treatment this morning. My foot has a tendency to fall off the brake pedal and back on to the gas. Judy is my chauffer. I had always taken a certain pleasure in being her chauffer during the fifty one years we have been married, but this is only one of the adjustments we have had to make over the last ten months. In any case, with Judy doing the driving I have the luxury of being able to take in all the sites and activities along the route. I watched the gardener carefully roll his lawnmower down a ramp off the back of his pickup truck as we drive up the street and past him. Before this last bout of cancer, I would have lifted that mower off the truck, and not wasted the time attaching a ramp and lowering it down as though the little extra effort of lifting it would have killed me.
My life has changed a lot. I have my own gardener now. I do not want one, but I have had one now for six months. I have always liked being my only gardener. I liked the physical activity, I liked to watch what I planted grow. I also took a quiet pride in the fact that at age seventy eight I was well able for the task. I miss it. Now I have a pool man who comes every week, and a handy man who comes and fixes things. With Judy, you could even say I have a chauffeur. She does the driving now as she does so many of the things that had been my responsibility.
“It’s going to be hot today. It’s hot already and it’s only ten o’clock” I said, looking over to her.
“A warm early spring day after the cold spell we just had kind of feels good,” she answered in a slow low tone that told me she was only half into the conversation. She had a busy schedule today.
“It’s too early in the year for this heat,” I ended the conversation. She was right I suppose, but I was not in the mood to give in or to pursue the conversation.
The medical building is only minutes from our house. It is a new three story structure with a large parking area around it. Even the security staff’s uniforms were new. I watched three security men at the front entrance just standing there, and wondered who was paying for a security staff big enough to protect a regional mall. For all the activity that was going on, or more accurately not going on, amongst the three of them, those new uniforms would never wear out nor would the three seat electric carts they drive around in.
As we had arranged it, Judy dropped me off at the front entrance, and after double checking that my cell phone was charged so I could call when it was near time to pick me up, drove off to her shopping, baby sitting, and grandchildren taxi chores. Another little irritant. I had always considered the cell phone an “electronic leash.” It was just a devise people used to disrupt your day or interrupt your work. I rarely considered anything so urgent it could not wait until evening when I liked to take my calls between seven and eight, after dinner and before quiet reading or TV time. That is changed now too. The “leash” has become a necessity for me.
The building is new and very busy. I went to the elevators where the usual crowd was poised ready to rush into the next car to open its’ doors as though the next car would be the last lift of the day, or if they got on the elevator last they would be last to get off. Many would also give the call button another push or two as though their pressing the button again would bring the car faster. One of the three elevators did come in its’ own time and I got to the third floor at the same time as the lady who stepped in front of me getting on.
The Hematology and Oncology section is just around the corner on the left from the elevator. The first room of that section is a reception area with two very busy young women behind a desk. The rest of the room was waiting area with seats along the wall which were used mostly by those that have doctor visits. Beyond the reception area was the restricted section with the doctor’s offices to the right and the infusion area straight back. I approached the reception desk to sign in and get my wrist band from Beatrice or Lisa, each talking into a telephone head set and working a computer keyboard.
I had forgotten what normally greets me as Beatrice was the first to look up. She just opened up with a smile and a small wave as I approached, never interrupting what she was doing on the computer or her conversation on the telephone headset. It was not one of those wide Pollyanna smiles, but just enough to let you know you were truly welcomed. I forced myself to smile back since this is the courteous thing to do. I just hoped the smile did not appear forced. Lisa reacted the same in her turn, a glance over, a smile, and the continual operation of both computer and telephone. I maintained the smile I had produced for Beatrice, but it was a little easier to hold now. The adage is true, if you force the muscles on your face to produce a smile your attitude will follow. My attitude got only a little less hostile. I signed the check-in roster and stepped back to make room for a couple coming out the next room in case they may need to schedule their next appointment which one of the two behind the desk would have to do between phone calls and computer operations. I was only standing there a couple of minutes when my data came out of the small specialized printer on the desk. Beatrice ripped it off the little printer, folded it around a paper strap, and taped that temporary band around my wrist when she came around the desk to let me into the restricted area. I got my band without having said a word to her.
It was then when she spoke to me for the first time “How are you today Mr. O’Hare? Is it still nice and clear outside? It was so beautiful when I came in this morning,” she said, still with the smile.
“Still clear. Not a cloud in the sky,” I said without mentioning how hot I thought it was going to be hot less her enthusiastic mood be broken. The conversation ended since she was already on another call as she opened the door to the back area with her identification card and returned to her seat.
I looked back, always a little in awe of two people who took the time to personalize your visit in the middle of their multi-tasking operations.
I went on to the waiting area in the infusion area and sat down. I had long ago surmised that one of the things Beatrice and Lisa did with their computer was to notify the nurses in infusion that a patient was here. As usual, it was only a few minute wait before Heather came. Heather was the registered nurse who usually took care of me.
“Good morning Mr. O’Hare. Where is Judy?” she said as she stood there, standing erect with my file folder cradled in her arms and a smile on her face.
“Doing the shopping, baby sitting and taxiing the grandchildren. Our daughter-in-law has a doctors’ appointment, and the older children get out of school early today.”
“A typical grandmother day. You are looking good this morning. You have good color in your face,” she said as we walked to the scales for the routine weighing in.
“One hundred and forty seven, good, very good,” she commented as I got off the scale. “Your blood count is really good too. I would like to see the platelets higher, but everything else is really up there.”
She had a way of ignoring the fact that I had gone down in weight from one hundred ninety five to one hundred forty pounds. The seven pounds from my low to the present one hundred forty seven were all that seemed to matter. I was on my way back up, and that was what I also now focused on, that and the good blood count.
“How about a little hydration today,” she added as we walked to one of the twelve stations that ringed the three outside walls around the nurses station and administration section of the infusion area.
“Good,” I replied, not knowing how she knew I was feeling a little more weak than normal. Hydration relieved that feeling. Somehow she was able to tell when I was down like that. I surmised it was in the blood count. In any case I appreciated it.
“Did Michael’s wife have the baby yet? She was due the end of last month wasn’t she?” Heather asked as I sat down in the recliner in station eight.
“Yes. She had a beautiful healthy boy, Declan James,” I replied trying to hide my amazement. It had been six or seven months ago that Judy told her Vicky was expecting and when she was due. The ability to recall facts like that was a sign of a gifted memory or a genuine interest or both. I decided it was both.
“You and Judy must be happy. How is your daughter-in-law?” she asked as she moved a small table on rollers holding all the needle kits and tubes she would use in the procedure.
“We are happy about it and Vicky is doing very well,” I replied as she went about attaching the collection devise to the port that had been implanted under the skin in my upper chest ten months ago. The port gave direct access to my vein so there was no sticking needles in the arm or veins collapsing over the months of treatment.
“Do you want a warm blanket?” she asked.
“Sure. Why not?” I answered as she went off.
She returned a few moments later with the blanket and two of the familiar clear soft plastic pouches with tubing coming out of the bottom that she would hang on the top of the metal single pole standing next to the chair. The pole had two pumps attached to it with clamps half way down and a curling bar extending from the top that was used to hold the pouches. She hung the hydration fluid and a pouch of anti-nausea medication from the top bar then opened each of the pumps in turn and pressed one of the plastic tubing’s from a pouch into it, closed the door on the pump, joined the two tubes together at the access devise that she had just attached to my port, then dialed in the rate of feed for each pump. I was ready for the two and a half hour session which would only interrupted by changing the empty anti-nausea medicine with the chemo.
“Declan James is a really unique name. Is he named after a relative?” She asked as she completed the initial startup procedure.
“No. They just decided on the name,” I replied.
“A really nice name. You and Judy must be proud,” she said as she left to go on to the next patient after I replied in the affirmative.
I settled into two and a half hours of semi sleep, listening to the conversations around me, and meandering thoughts of where I was in life at this time, saying a few words to my Creator who has a lot of help from Dr. D whom I consider a genius at this chemotherapy business. I listened to the conversation in the adjacent station on the other side of the curtain. I recognized Marta’s voice talking with her patient about a new wig the patient had bought. The conversation was filled with all those words women use when talking about anything cosmetic like beautiful, darling, etc. In the station on the other side, they were talking about that patient’s weekend trip to his daughter’s house. I realized then for the first time in ten months that there seemed to be more conversation going on here than at some of the company parties I used to have to go to when I was in the business world.
As usual, the time went by quickly, interrupted about half way through by changing the empty pouch of anti-nausea medication with one containing the chemotherapy. The completion of the session is always the same. The pump feeding the fluids sounds its bleeping signaling that the pouch is empty. Next, Heather disconnects the tubing and injects a saline flush into the port followed by an injection of an anti-coagulant. I am then given a paper directing the front desk to schedule me for the next blood draw and chemo in two weeks. At this time I called Judy to tell her I was ready to be picked up.
“Good bye. Be sure to say hello to Judy for me now,” Heather said as I left.
“I will. Good bye and have a nice day,” I answered as I was leaving. It was a typical session. I stopped by the reception desk where Beatrice scheduled the next two appointments. I said goodbye as Beatrice gave a little wave of the hand and a smile as I went on my way. I would almost say the little wave and smile were routine were it not for the fact that I have never taken them for granted. I appreciate them each time.
I kept thinking about Dr. D on the way down in the elevator and across the lobby. It has been ten months of chemotherapy. I have had very little pain and even less nausea up to this point, even with the neuropathy, and these sessions are virtually pain and nausea free. I often wonder how Dr. D is able to balance the chemotherapy infusion treatment considering my age, irregular heartbeat, and this is my third case of cancer. I had to be taken off the oral chemotherapy the last time because it went after my heart which leaves me with only the infusion treatment. I wondered briefly if he knows how important he is, but realized he is reminded of that a hundred times a day when people call him “Doctor,” and I also try to make it clear during my visits with him. Yes, I am very sure he knows how important he is.
I stepped outside into the a lovely clear bright day as one of the security guards drove up in his electric cart with an elderly patient and her caregiver which he had picked up in a remote area of the parking lot. The older woman dismounted the cart and slowly made her way inside the building with the help of the caregiver. I stood there for a minute, enjoyed a slow warm breeze, and collected my thoughts. Yes Dr. D certainly knows how important he is, but, I wonder if Beatrice and Lisa at the reception desk, and Heather and Marta and Ana and Jennifer and all the other nurses know how very important they are. I sincerely hope they do.