ROOM 4512 | Suzanne Travis
LUCK
In between the “Go Dodgers'' and the “I Love My Harley” tattoos, I found the perfect spot. I said a silent prayer and steadied my hands. The vein was barely visible, hiding under his left wrist. I felt like a huntress with laser sharp focus, aiming at my target.
My patient was tired of needles and nurses with excuses. His veins were either too deep or too small or they rolled. He probably wasn’t drinking enough water. He said he felt like a voodoo doll after being stuck so many times. I laughed when he said they were “vein shaming” him.
I told him to take some slow deep breaths and make a fist as I tightened the tourniquet around his arm. “Just go for it,” he said. “And please don’t count to three. It makes me even more nervous.” He was already an hour late for his morphine.
“Did you get it?” His voice was hoarse, desperate.
“It’s bad luck to say until I’m sure. Kind of like a nursing superstition.”
“Baseball players have tons of those,” he said.
“Let’s hear some.” He needed some distraction. Something to talk about besides cancer. Something to think about besides pain.
“Here’s one. You never step on the foul line on the way to the dugout.”
“Good one! I’ll be sure to remember that if I ever play baseball.”
His head was craned towards the window with his eyes clenched shut. Then, a flash of red as blood filled the catheter. Red, a color with many meanings. Passion. Power. Good fortune. A color that signifies success.
I held my breath as the needle slid smoothly into the vein. A perfect port of entry for the morphine to travel into the bloodstream. Where the poppy seed elixir would surge and swirl, perform its magic and ease the pain.
Starting an IV on patients considered “hard sticks'' was admittedly an ego boost. But skill was only part of it. Maybe it was luck. Maybe my nursing superstition paid off. “Never say you’re in until you’re in.” Finally, my patient could get his long overdue morphine.
“We’re In!” I taped the IV next to the “MOM” tattoo, a tiny pink heart with wings. “You’re lucky. I just missed poking the eye of your Centaur, or whatever that scary looking one is.”
I could tell it hurt to talk when he thanked me. The chemotherapy had ravaged his throat and gargling with magic mouthwash (milk of magnesia and lidocaine) made him gag. I gave him a thumbs up as he fell back into bed and waited for the pain to subside. Not entirely, but he was used to that. When the pain became bearable, he remembered what it was like to feel human again.
I tucked him under his special blanket, covered with photos of family, friends and his two dogs. One of the pictures was my patient, posing by his Harley in a black leather jacket and boots. He smiled behind his beard and sunglasses, holding a beer in one hand and what looked like a joint in the other. Surrounded by his biker friends, he towered above them like a giant, looking fearless, unstoppable, immortal.
Before leaving the room, I noticed the tattoo emblazoned across his bare chest. The big block letters were blurred and faded and hard to read. Looking closer, I could see the cryptic message in black ink. “This Too Shall Pass.”
Looking back, I think that morning is when we formed our special bond. Or maybe it was the song. The first day I met him, “Personal Jesus” by Marilyn Manson, was blasting in his room. I started nodding to the music and said the Depeche Mode version was so much better. Less dark. Punchier. His wife said Johnny Cash did it best. Sexier. More soul. “
“You’re both so God Damn Wrong!” he yelled over the music. His wife, still wearing her pajamas and slippers, grabbed my arm and we performed an impromptu dance at the bedside. We kept it up until the charge nurse came in and asked us to please turn down the volume. It was the first time I saw him laugh.
NAMES
We referred to him by his room number during rounds in the hallway. Called him 4512 to protect his privacy. Some called him a “difficult patient.” Others called him a thirty-one-year-old male with “drug seeking behavior.” The charts were less judgmental, referring to him by his diagnosis: end-stage pancreatic cancer. Uncontrolled pain. Poor prognosis. Pure and simple.
I called him Manny.
On a floor full of twenty-somethings, I was referred to as the “seasoned nurse.” Manny said at least I was spicy. Like Hot Cheetos. Or Hot Tamales. Or one of the Spice Girls. And the new nurses were bland, like mayonnaise on white bread. Or vanilla ice cream. He added that none of them gave his pain medications the right way, like I did.
I explained to the less experienced nurses that it was safe to give his intravenous morphine thirty minutes early. And if he still complained of pain, to get an order for an extra dose. And no, they didn’t have to dilute the morphine with normal saline in the syringe. And they didn’t have to give it slowly over ten minutes while he’s writhing in pain. And they didn’t have to ask the same old question, “What number is your pain on a scale of one to ten?” Just assume he’s a ten. And by the way, he’s dying.
“I think he likes the morphine given fast, just to feel the buzz.”
One of the new nurses was giving me the end of shift report outside his door.
“And he’s SUPER demanding!” She was starting to whine and I resisted the urge to ask if she bothered to read our hospital mission statement. The part about alleviating suffering and providing dignity to the patients. The rest of the nurse orientees were huddled together by the elevator, giggling about something and looking at their watches.
“Sorry they’re rushing me, but we’re going to Happy Hour to celebrate finally finishing orientation!”
Manny was waiting for his morphine and the new nurses were waiting for their cocktails. Everyone was waiting for something. I decided to speak to her privately, when we had more time. About the things they don’t teach you in nursing school.
Manny called her “Sanctimonious Sara.” Said that she wore an imaginary halo, like a tiara, over her blonde head. None of the nurses escaped his secret nicknames. “Jail Warden Jessica'' and “Miserable Maria” worked days. “Perky Patricia” and “Sorority Suzie” worked nights. “Judgmental Judy” was the unit director. After spending over two months on our oncology floor, he knew all of us well.
The Palliative Care Chaplain was named “The Grim Reaper'' after an end-of-life conversation that didn’t go well. Manny said he felt more depressed after they spoke than before. He agreed with her that he needed to “get things in order.” But told me later that she was more somber than a funeral director. And wanted to tell her that he wasn’t dead yet. We decided to change her nickname to “Buzz Kill.”
He named his oncologist “Dr. Gandhi.” Manny described himself as a lapsed Catholic, but said if he worshiped anyone, it would be his doctor. He remembered when she sat on the edge of his bed and got teary-eyed while explaining the chemotherapy wasn’t working anymore. And it was time to consider palliative care. But the good part was he would have better pain management.
“So, the only difference is…. now I’m dying with pain, instead of living with pain?” She was silent, caught off guard. He patted her hand, offered her a Kleenex and said he would be OK. And she would be OK too. And then she cried harder. After his story, I decided to call her “Dr. Gandhi” as well.
WISHES
After giving his morning dose of morphine, I watched his angular features soften. Still wearing his blue Dodgers cap, he looked almost childlike as he drifted off to sleep. He was so thin, he seemed to disappear under the white sheets. I watched him become one with the bed and sink into morphine oblivion.
It was a little past 7:00 am and the breakfast carts were rumbling and rolling in the corridors. The hall lights switched on with a click and fluorescent glare marked a new day. Outside the hospital, pale light was breaking through the fog, revealing a gray and lavender sky.
Inside the break room, after much debate, the Make A Wish New Grad Nurse Committee had made their final decision. Manny was chosen as the Patient of the Month for December. A perfect project for the enthusiastic new nurses to sink their teeth into.
Making memories for terminal patients was both gratifying and mandatory. They could fulfill their requirement to serve on a committee while fulfilling a patient's dreams. Granting wishes was way more fun than bedsore prevention on the skin care team.
Now Manny was about to be told he was December’s project. They just had to wait until his wife came back from the cafeteria. She returned with a dozen bagels for the nurses and pancakes for their six-year-old daughter, Louisa, still sleeping on the fold out bed.
That’s when he was given the good news, that he was the lucky one. The chosen patient whose wish would be granted by the Make A Wish New Grad Committee. They didn’t say, “Last Wish.” They didn’t have to.
He gave his wish to his daughter, who had never seen snow. Now she would. New Grad Debbi called the snow delivery place. Ashley covered the press. Brenna ordered the fancy cupcakes from Sprinkles bakery. Kirsten rented a sparkly blue princess costume to look like Anna from the “Frozen” movie.
Two trucks carrying the snow had a few minor mishaps while beeping and backing into the parking lot. The rest went smoothly and soon the grassy plaza was blanketed in snow. Manny said it looked like a blizzard just hit Los Angeles and global warming was no joke.
He was given a Santa costume that hung on his frame. And a matching hat that kept slipping off his bald head. A white felt beard was strategically placed over his oxygen mask while someone else hung a red bag with toys on the back of his wheelchair. He held his daughter’s hand as he was wheeled downstairs and greeted by applause.
Since I had a late lunch break, I missed seeing the entire spectacle up close and had to watch from the fourth-floor window. Snowmen were made and snowballs were thrown. The “Frozen” princess hugged the daughter and posed for pictures.
After about an hour, the crowds disappeared and sounds of laughter faded and all that was left was a couple of misshapen snowmen, already melting. One of them wore a stethoscope. The other one wore a nursing cap like I used to wear in the ’80s.
Louisa was breathless when she bounced out of the elevator, and back onto our floor. Her mother wheeled the fading Santa back into his room where I was waiting with his morphine.
Now it was my turn to take my break and see the winter wonderland up close. Louisa grabbed her pink mittens and begged to come along. Her red-eyed mother said, of course, but only if I reminded her to not get wet again. She was wearing the only pair of dry shoes she had left. And they couldn’t go back home that night to change. I promised to keep her safe and sound and dry and off we went.
It was quiet with just the two of us. A perfect stillness. The hospital walls disappeared and her father wasn’t sick and there was only sky and snow. A magical snow globe with just the two of us tucked safely inside. I watched her throw snowballs before hurling her entire body into the snow to make snow angels.
When she asked if the snowmen would still be there in the morning, I wondered if she was thinking about her father. If she worried about waking up one day and he wouldn’t be there anymore. We decided to bring him back a snowball. She could surprise him with it when we got back and she could store it in the nurses’ lounge freezer for safe keeping.
It was hard to convince Louisa it was time to leave. The pink-cheeked child that I was solely responsible for was soaking wet. The one whose mother I promised to keep dry was covered with snow from head to toe. She giggled when I said she looked like a giant Christmas cookie dipped in powdered sugar.
“Your mom is going to kill me!” I yelled as we ran back inside.
“It’s OK! I promise she won’t care!”
Manny didn’t die until a few days after Christmas. I wondered if he waited on purpose. Another wish for his daughter
Suzanne Travis lives in Los Angeles with her husband and four rescue dogs. She is semi-retired after working over twenty years in oncology nursing. She continues her love of working with patients as an infusion specialist in a clinic and at patient's homes. As a former stand-up comic, she found humor to be therapeutic with her patients. During her free time, she pursues her passion for writing and hiking in her neighborhood canyon.