Cathy has remained a vast part of my life since her passing. I think of her every day. She is included in my daily meditation, as she seems somewhat like an angel or a muse. I ask her for guidance especially when I enter the ER and I feel her around me. Even my daughter says hello to her and Rhonda as the sun is setting. That’s where I feel Cathy and Rhonda the most. Both lives cut short from cancer: both souls that changed my direction and existence forever.
I have witnessed enough coincidences to know that there is no such thing. So why this week completely blew my mind, I still have no idea. I should be used to her presence. But when it gets so extreme, I still remember I’m human and still have utter awe of this world, this life and that amazing place beyond our physical existence.
My gut recognized this week would be intense but that was only because I knew I would be working four straight shifts in a row at the insane ER that I try not to frequent. I certainly only pull two, maybe three shifts a week as a max because I have learned that my sanity is way more important than money.
The place is like an abusive relationship. Dysfunctional as hell but always drawing you back in. And that’s because the staff and patients forever find a way to pull at my heartstrings despite the disgusting bullshit administrative antics that only seems to waste my precious time.
It was no surprise; the hallways were filled with disgruntled patients lying on urine soaked stretchers as all fifty-two real ER rooms were filled while EMS continually pounded us with their 911 calls. Strokes, heart attacks, drug seekers and fakers poured through the ambulance bay and the waiting room doors as every possible dinging call bell and alarm went off. We had all learned to ignore this discordant, grating melody.
Oddly enough, I was not fazed by the chaos or drama of the ER. I didn’t even care that my slack ass partner chose to surf the Internet and update his Facebook status while I did most of the work. Maybe all that meditation was really paying off.
My days now all started with a prayer and brief meditation. I never thought of myself as religious and I still don’t. But Cathy and Rhonda made me believe there was so much more than just this physical life. They had been helping me tap into that awesome love and power that we all have access to.
So each day I start by being grateful to God for my life and my many blessings. I ask that he work through me. Guide me to be the best person, mother, and doctor that I can be. I ask Rhonda and Cathy to hang with me and touch a patient’s life and receive whatever lesson or love I need in return. I then calm and clear my mind for a brief moment.
I sometimes throw a rock or two in my pocket to ward off any negativity because let’s be realistic, some of these patients are just batshit crazy. The nurses think I’m also nuts as I jabber away sipping my homemade whole food smoothies. Puke in a bottle as they are lovingly referred. It must be laced with cocaine as no one has quite figured out where I get my energy. I gave up caring a long time ago. It’s who I am and it works for me.
It was midway through my shift when the medical yellow alert came across the radio. That just means the patient is close to checking out but is still breathing, barely. Upon entering her room I saw death in her eyes. I’ve seen that look so many times before. There is an initial sense of fear. But that is just air hunger or not getting enough oxygen. The body tries to compensate by rapidly breathing and using every muscle it can to take in just a little taste of that life-sustaining gas. The eyes are always dilated and almost bulging out of their head.
She was leaning forward but I could still see her protruding abdomen. She looked nine months pregnant but her belly felt hard as a rock. Her gut was dead and so was she. It was just a matter of time. I knew instantly that I could not save her. She would never survive the surgery.
The paramedic tried giving me a history but all I could do was run to her side and grab her hands. “Are you in pain?” I asked. “No I don’t think so,” she replied as she gazed tenderly into my eyes and squeezed me as she grimaced with any little movement. I was amazed she was still that conscious. I shouted to the paramedic to shut up as I had only one question for him. “Is she a full code?”
He explained that technically yes she was to be resuscitated because the daughter could not find the paperwork that she had signed to prevent people like me from cracking her frail ribs by doing CPR. I looked at my patient and then my crew and whispered, “let’s keep her alive until I can speak with the daughter.” I refused to pound on this woman’s chest or stick a tube into her windpipe. She was immaculate, she was awe-inspiring and she was ninety-two. This was her time to die and we all knew it. I wanted to give her peace not torture the poor woman. I needed the daughter.
I also needed the Terri-nator. She was the ER’s case manager and really an angel with an attitude. She made shit happen and if anyone could find the daughter I knew it would be Terri. Within moments I was having a discussion with her daughter about her mother’s impending death. There was guilt, there was sadness, there were tears, and then there was that beautiful selfless moment that always fills my heart. “I don’t want to lose my mother but I don’t want her to suffer. Please make her comfortable and let her go. That is what she has always wanted. She just told me yesterday that she was ready to see my father and my son who just died one month ago,” as she burst into tears. Human strength under dire circumstances is simply amazing.
Moments later I left the room with Terri to go ease this woman’s suffering. “Dr. ChaCha I’ve noticed you rub your wrist every time you speak to a person about death. I know your story and I think that’s beautiful.”
Tears filled my eyes. I had never realized I did that. My right wrist bears a tattoo of a lotus flower with many colors. Each represents the women that helped me blossom. Of course, both Cathy and Rhonda are a part of the color scheme, teal, orange, purple and gray. I had unconsciously been asking them for help, as a patient was about to transition to that great beyond where they resided. I just needed the Terri-nator to point it out.
An entire entourage gathered around this elderly goddess. She was showered with love, hugs, and kisses. She knew she was dying and she was at peace. I helped her and the family get there. They helped me feel that beautiful gift God had always given me to help people transition from this world serenely. I left the ER that night with my own grateful peace. She finally departed at 2 am the next morning with a smile left on her face I heard. Driving home, I cried knowing I was blessed to witness such raw, beautiful moments.
I knew God, Cathy, and Rhonda were all working through me. She was just one of the many patients that tugged at my heartstrings and reminded me how very fortunate I was to be their doctor. I wondered what my last shift of Cathy’s birthday week would bring. I quickly found out early the next day.
It was another total shit storm. Florida ERs in February are slammed due to all the snowbirds on top of our regular sick folks. The hospital is always at 200% of its capacity. Patients spend days in the ER just waiting to get upstairs to a room.
At least today we had an excellent crew that all pulled their weight. We were also great friends and loved to laugh and joke in the midst of saving a life or two. That morning we even had a patient’s wife walk up to us and ask us to please hold it down. We were clearly having too much fun at our job and laughter is just simply offensive and out of place in an ER. My initial instinct was to throw a smart-ass comment her way. I held my tongue and rubbed my rock. I could see it in her face. She was tired, scared, and had no clue that our laughter helped us blow off the steam of staring at death every day.
And then my merriment was cut short. The nurse handed me an EKG. She was concerned that the 41-year-old male who was just transported by EMS and had passed out completely in front of his wife might be having a heart attack. It was a concerning EKG. I stood up from my desk to rapidly go see him and then I almost hit the floor as I heard the nurse mumble, “He was just diagnosed with a brain tumor.”
“What kind?” I gasped. “They don’t know yet. They are supposed to find out the biopsy results this week.” I grabbed my wrist and I knew. I had not even seen him yet and my gut told me he was going to have the same terminal brain cancer that had taken Cathy’s life.
Walking into the room and seeing his already frail body lying on the stretcher just breathing, I saw Cathy. Taking a deep breath I walked over to examine him and as soon as I touched his hand I could feel Cathy. Scanning the room I saw his strong, baffled wife trying to hold back her tears as she waited in the corner as to not interfere with our work. She had the same distraught facial expression that I remember seeing on the face of Cathy’s husband. The nurse quietly beckoned me over to her computer. She had pulled up the biopsy results: stage 4 Glioblastoma Multiforme. Yes, Cathy was all around me just like she is every day but this was so intense. Was this her birthday gift to me?
I excused myself from the room to get him to CT immediately. I already knew most likely the swelling inside his brain would be massive. He could need emergent brain surgery to sustain what would be for him a very short life. I stopped to wash my hands, looked at Kim the nurse and just burst into tears. “I’m sorry”, I said. “It’s just that in two days my dear friend that died of the same brain tumor would be celebrating her birthday.”
After wiping away my tears, I started to talk about Cathy. I had a fourth-year medical student shadowing me. She along with several staff stopped to listen to Cathy’s story. It is a beautiful story and I never get tired of sharing it. My student just stared at me in awe. She had apparently decided to go into Dermatology but had always thought the ER would be fascinating. She was now second-guessing her choice as she was witnessing first hand the true beauty of life and death. I reminded her that she always has a choice and that same magnificence can be seen in many places, not just the ER. All you have to do is open your eyes and your heart and be willing to allow it in. Cathy did that for me.
His CT returned and the swelling was not only massive but so was that tumor or gremlin, as Cathy liked to call it. His entire brain was being shifted to the left. I could not believe this man was still awake and able to move all of his limbs. I called his neurosurgeon stat. He seemed genuinely sad when he told me there was nothing he could do surgically. The biopsy had shown very aggressive necrotic tissue. All we could offer him was supportive care. I gulped back the tears. This man would not last nearly as long as Cathy. I felt so fortunate for all that precious time she was given, every single second.
Entering his room, I spent a little time just chatting with him, making sure he was comfortable, even laughing and joking with him. Escorting his wife outside the room so that we could speak privately, I gave her the news. I explained the biopsy results, that he had a terminal brain cancer and that his CT scan was much worse than just a few weeks ago. And then I shared a little bit about Cathy with her and how very much I understood this disease not only medically but also personally.
I hope my words helped in some way. I hope I gave them some comfort that terrible day, the one day she will never forget. The day a doctor delivered the news that the love of her life would surely die and quickly.
I thought of Cathy’s family, her husband, sister, brother, mother, and all those that loved her. I prayed that in their sadness that they also felt great joy to have been part of such an extraordinary life. A life that continues to inspire and comfort people even after it left us physically. And so yes I do believe this intense week was a birthday gift from Cathy. I hope her gift reaches you as well.
Happy Birthday my dear Monkey Sister! I love you forever!
Image: DepositPhotos.com
