Too close?

Friends.  Tonight I come to you as a defeated PA, a human filled with sadness but a Christian clinging tighter to her faith than ever before.  I apologize it has been a while since my last posting.  It has been a truly challenging couple of weeks.  My doctor has been away for 16 days.  For 16 days I have taken care of my deathly ill oncology patients.  For 16 days I have taken call.  For 16 days I have felt far older than my 26 years.  And I am defeated, with only the strength of Christ carrying me.

In medicine, especially oncology, we are continuously reminded to keep our distance from patients.  To show them compassion, but for our own sanity leave it all behind.  That this is the only way to preserve oneself in such a stressful profession.  This is an aspect of medicine I truly struggle with.  Medicine is not just my profession, it is who I am.  Soon, I will be living my life in medicine.  When I am in the DR, will it truly ever stop?  Will I ever eat a meal without someone asking my medical opinion?  Will there be nights when I am awoken with a deathly ill patient?  Will I ever not be on call?  I love my patients.  I think about them throughout my day, not just when I am sitting in the office.  I am incapable of "distancing myself."  But, I ask if that is truly wrong?  Is it that distance health care providers create that makes them stop caring?  I bring to light these questions because perhaps I allowed myself to get too close.  Or perhaps, in a controlled environment, God is teaching me and preparing me for what is to come?

In the many patients that I have had the privilege of taking care of in the past year, none compared to my truck driver.  We bonded immediately.  He was young, 47 with a wife and 3 children.  And he was diagnosed with stage 4 metastatic disease.  Ive taken care of him for 14 months.  He started on chemotherapy when I first joined the practice.  We met weekly.  He hated coming in to my office because of what we represented, a shortened life span.  But he was compliant, and I worked with him.  I even met with him in his truck in the parking lot one morning.  He was given a year to live last summer.

I was convinced I wasn't going to be here when he passed, that we would keep him alive.  I knew I couldn't handle watching him die.  It has become harder and harder as I lose patients because I've taken care of them for longer and longer.  The day before my doc left for vacation this patient developed extensive disease, we did all we could.  I worked with his family very closely.  They even came to my office everyday.  On Friday I had to place him on Hospice.  Two hours later as I was on the phone with his wife, he took his last breathe.  I was there everyday, through it all.  Just me.

I was and still am heartbroken.  How can this be?  I find myself remembering the last conversations we had.  His wife telling me he was the best.  So simple, yet true.  He was the best.  And to be taken away so young.  I miss the phone calls I would get from his wife.  I miss helping him through his symptoms.  I miss speaking with him.  I didn't want to be here for this.  And here I was, not only here but calling the shots.

And yet, a midst my tears and pain, God was present with me.  I could not have cared for him without our Father.  Everything played out as it should have.  I was meant to be here for this.  God had his hand in everything, from beginning to end.  When his wife called me, to confirm he had died, she phrased his death as "passing on."  What a beautiful way of thinking about death.  Passing on to where there is no sickness.  To where Jesus has prepared a room in his house.  On Earth we are saddened by what people are missing out on  here, but perhaps we are the ones missing out.  Less time with our heavenly Father.

Tonight, as tears continue to fall, I trust that my patient is free from pain.  That he is sad being separated from his family but rejoicing with our Father.  I refuse to stop caring and loving my patients.  Is that what Jesus did?  Stopped caring when things got too hard?  What better time to love people fiercely than when they are facing death?

I'm not quite sure how to make sense of the past couple of weeks.  I'm not sure how I'm going to walk back into my office on Tuesday and continue caring for my patients.  To pretend that I am not affected by losing a patient.  I do know that I will never stop loving them, regardless of how many more "truck drivers" I have in my life.  I will never stop giving my all regardless of the toll it takes on me.  Isn't this why I'm called into medicine?  I will continue to give my everything, always looking above for strength and striving to be more like the ultimate healer.

Please keep my patient's family in your prayers as they are grieving the loss of this wonderful man.