Sometimes, when you first care for a patient, you’re not always sure if you’ll develop a bond. You wonder if you will mesh with him or her. I felt this way when I first cared for Mary Beth.
Mary Beth was a high school freshman who lived with her mother in Boston. Her father lived in China. She often translated for her mother, who did not speak English. She was an excellent student who loved movies, shopping, and The Cheesecake Factory restaurant.
A few years ago, tests revealed that Mary Beth had a large malignant tumor. She started radiation emergently and was admitted to our unit for chemotherapy. That was when I began caring for her. Mary Beth was quiet and self-contained. Her mother, in a culturally protective stance, did not want cancer discussed with Mary Beth. She was simply told she had a “growth” that was causing her symptoms. We had to teach Mary Beth and her mom about the side effects of chemotherapy, ways to recognize complications, and times to return to the hospital without really delving into her diagnosis. She accepted our teaching and asked very few questions.
I often felt helpless caring for Mary Beth — she seemed so vulnerable, and chemotherapy was rough for her. It was a challenge to help her feel better. The amazing thing about her was her strength of character, her quiet dignity, her ability to tolerate the rough days. I was in awe of her beautiful, serene spirit. I found myself feeling more and more connected to her.
Mary Beth and her mother practiced a coping ritual that I witnessed. After dark, her mom would get on her bed and gently apply pressure to different areas of her body while whispering in Chinese. I respected this ritual and tried not to intrude. I acknowledged her mom’s efforts to comfort Mary Beth. And I felt her mom needed to know she was helping.
Nursing presence has become the cornerstone of my practice. When all else fails, being present to share the pain and sadness can help. Sometimes, I’d sit next to Mary Beth and try to convey my caring and empathy. Not with words. Just by being there. She seemed comforted by this. It became our ritual while her mother slept.
Mary Beth and I grew in our relationship. I would joke with her about how self-sufficient she was, about how little she let me do for her. After that, she began to call for me more often and let me do more for her. This was a big step. I believe it reflected a growing trust and comfort level. She felt empowered.
Unfortunately, Mary Beth took a turn for the worse. She and her mother decided to return to China and resume treatments there. We continued our relationship with the help of e-mail.
Initially, Mary Beth sounded hopeful and energetic despite her treatments. She had good days with friends and was busy being tutored at home. The rest of the staff and I corresponded with her regularly. I wanted Mary Beth to still feel connected and cared about by us in Boston.
As time went by, she became tired, weak, and eventually bedridden. I could sense sadness in her words. I e-mailed back words of encouragement and peace to her. I still respected the boundary set up by her parents: no cancer talk.
Suddenly, there were no more e-mails. In my gut, I felt that Mary Beth had died. After a few months, I received an e-mail from her father, whom I had never met. He confirmed my suspicion. Mary Beth had died peacefully with her parents by her side. He expressed his gratitude for the care we gave to her and thanked me for staying in touch when she moved back to China. My last e-mail to China was to her parents, acknowledging their loss and praising them for raising such a beautiful daughter. I told them I was honored to know Mary Beth and to care for her.
Sometimes, when you first care for a patient, you’re not sure you’ll develop a bond; but sometimes you do, and that bond transcends time and oceans. It’s a bond that enriches you as a nurse.