Pam and Sybil
Tracy had won an award, like Peg did, from the PLTC group for ‘outstanding work.’ The award is called the “People Caring Award” and, as usual, Tracy said it was wonderful to get but she didn’t think that she and Peg did anything special to deserve it.
“Just doing our job, that’s all,” she said, bustling back and forth with IV tubing in her hands, smiling. “That’s all.” Mary, the patient sitting in the recliner with the IV in her arm, laughed. “Just doing a job, that’s right. A job like none other.”
Mary put her head back on the pillow. She looked pale and ill. Tracy adjusted the afghan around her legs and checked the flow rate of the IV. There was worry in her eyes when she looked at Mary, but no one saw.
This is another one of Tracy’s stories from the therapy room.
I went to get our new patients, our two new patients, old nurses. They sat in the waiting room, one sitting at the computer we used for education for patients, the other in a chair, legs crossed, flipping magazine pages and not seeing anything. They both looked up at me when I came in with their charts.
“Pam Dempsey? Sybil Crowe?” I didn’t know which was which, but I had heard about them from Peg, who knew them both pretty well. They had appointments at the same time, so we would take them together into the therapy room.
They were both tall and big boned; they wore their gray hair short and didn’t fuss with it. They wore businesslike suits, blouses with big soft sleeves, no-nonsense shoes, little jewelry or makeup. They sat in the waiting room tapping their feet.
“We know what you have to do, so let’s get this over with” was their attitude, and who could blame them? These were people who made things happen; they looked at their disease as a glitch in their lives, something to deal with, dust off the hands, and get back to work. It was a great attitude, but Peg was right.
“They’ll be checking IV’s and charts and making sure the blood counts are on all the charts,” she sighed. “And they won’t believe anything until they see it in the chart or on the computer.”
I looked at Peg and smiled. If the positions were reversed, she would do the same thing. So would I. Most nurses manage their own health care; it’s inbred. It saves time, mistakes and agitation. And it keeps people in charge, something a cancer patient needs to be. So I figured we would treat them, listen to their stories, and let them manage what they could. In a few weeks we would send them off to the radiation clinic after a break.
They would become my pets, no matter how much they resisted. Peg doesn’t have many pets among her patients, but I do. There are some I can’t forget, and I figured these two would be among them. I was right, but for a much different reason that I thought that first morning.
The woman at the computer turned to me and said briskly, “I’m Pam, and this is a good educational tool. Why don’t you advertise it more? All you have up is this measly little sign at the door....” she pointed at the little sign on the wall, and I thought, “She’s right, we need to let more people know about this program...” and realized she was the administrator from the hospital and would know about things like that.
“Don’t listen to her, she’ll have you painting the walls and recovering the cushions on these chairs.....” Sybil looked over her glasses at me, and glanced around at the furniture, and I tried not to laugh. Peg was right, it was going to be a challenge. We’re up to it, I hope. I watched them walk down the hall into the therapy room, walking briskly at first, with a purpose, and then slowing down just a bit as they got to the door.
“Is this it?” Sybil walked in and looked around. She looked at the comfortable lavender recliners where they would sit, near the IV poles waiting for them. She wandered closer and peered into the little pharmacy room with its Dutch door, and looked behind the screen and saw the sink and cabinets and refrigerator where we kept supplies. She looked at the macramé pot holders, and the plants with their glistening leaves, and the cards and mementos from patients that we kept pinned to the screen. She nodded, looking pleased. Pam was doing the same thing, around the other side of the room, looking into the back treatment room where the two beds were, empty now, tidy and clean.
Peg was sitting at her desk working on the computer and looked up over her glasses at her two new patients.
“This is it, ladies, let me give you the tour.”
She walked them around, explaining what was what, and pointed out the area where the brochures were, and the patient education pamphlets. She picked up two or three and handed them each a copy, and gave them a look.
“I know you’re both nurses, but read these.”
Pam looked at Sybil and stuffed the brochures in her large purse. They would read them, but we’d probably never see it.
Peg and I got the intravenous tubing and medication ready, and they sat in two recliners, shoes off, looking fairly comfortable. Pam looked over at Sybil and said,
“You going back to work when this is done?”
Sybil turned her magazine over and said, “Of course.”
They both looked at Peg, who was arranging tubing on the blanket around Pam and wiping her arm with alcohol before starting the IV. Peg looked bland as vanilla and said, “Of course. Piece of cake. We’ll have you out in about a half hour, no problem.”
Pam lay back in her recliner, and took a deep breath, and I started the IV in Sybil’s arm. It was quiet, the lights were dim, and we watched them, still and resting.
It was the second week of their treatment, and they had established their routines. They arrived at the same time, each with a briefcase full of work to do. They settled in the recliners, looking at their watches to make sure we were on time. They talked for a bit, dozed for a bit, and then when the IV’s were removed, they had some juice and a cookie and went to work. It was pretty amazing; they never seemed agitated or upset, or sick.
“Tough, that’s what they are,” Peg said. “Just tough.”
“As long as I’ve got Lifesavers I can chew after I throw up in the bathroom on Mahogany Row, that’s OK,” Pam said one day. “Then I can get back to work.” Sybil nodded, and Peg shook her head.
Pam had some tart words for our organization, too. She realized that we scheduled patients from the clinic when they saw their doctors, so it turned out that most people around 10 AM on a given Wednesday were breast cancer patients, while afternoons were men with prostate cancer or lung cancer. That’s the way the clinic schedule ran; and patients got their treatments at the same time as their clinic appointments so the doctors could look in on them in therapy. Treatment followed clinic, so we lumped people together. That’s the way it had always been, and like the ‘target’ marks on the radiation patients, no one ever questioned it. Until Pam.
“Mix ‘em up,” she said. “Mix lung cancer patients and skin cancer patients and ovarian cancer patients. Maybe hearing about someone else’s cancer once in a while would get some of us off our duff and thinking.” She was probably right, but things didn’t change much. They never did, here in the cancer center. The more people thought they changed things, the more things stayed pretty much the same.
We went along for several weeks, nearly the middle of the treatment for Pam and Sybil. They wore turbans and scarves when their hair fell out, and Pam sometimes just came in bald, with a new pair of dangling earrings and a floppy canvas hat. She tossed the hat on the recliner and sniffed.
“Damn wig scratches my scalp.” Terse and to the point, she dealt with it. “Had to have my head shaved, the stuff came out in handfuls but not evenly. I looked like I had the mange.” Like Honoria, she had her friends around her one day in the back yard and they celebrated a new mountain crossed by shaving Pam’s head. She put her thumb on her nose to the Universe, and kept going. Sybil talked to her sister nearly every night, and visited her several times.
They never seemed to change, those two. They asked a million questions, looked at their charts every day they came in to check on the results of the latest blood draw, and asked for cranberry juice instead of orange. Peg sighed but she sat and talked to them, listening to the stories they told about the floor and the administration hallway in the hospital. Pretty racy stuff, sometimes.
But on a Wednesday morning things changed. Pam came in, alone. She looked around and frowned. “Where’s Sybil? She’s bringing me a report I need from her floor....” and she stared at the door.
There was Sybil, dressed in jeans and a sweatshirt, something so odd that we nearly didn’t recognize her. She came in and sat down and put her head in her hands.
“She died. Nancy died yesterday.” In a small voice unlike Sybil’s she told us that her sister had been killed in an automobile accident. The strong support was gone; the closeness of two people was destroyed.
“It was supposed to be me,” Sybil said angrily. “I was the sick one, I was the one she was worried about. She was fine. And now, nothing is fine....”
She put her head in her hands and Pam and Peg and I stood there rooted to the floor. She shook my hand off her shoulder, and we didn’t know what to do. It was quiet in the room; we listened to the sound of the aquarium and the clicking of computer keys in Kate’s pharmacy as she worked. We looked at each other and Pam cleared her throat.
“What do you think she would want you to do now, Sybil? Keep going, or quit?”
Sybil’s eyes flashed and she turned to Pam. “I’ll keep going, she would have wanted that, but for what?”
Dr. Kazu came in then, and listened to the whole thing, and stood by Sybil’s recliner while Peg started the IV. He leaned against the wall, and looked at the ceiling. There were new lines on his face.
“Sometimes I get mad at God,” he spoke quietly, “but God doesn’t say much. Getting mad doesn’t help, because no one knows why these terrible things happen. All we can do is help each other as best we can.” He gave us a bleak sort of smile, and walked slowly back to his office.
Peg nodded, and squeezed Sybil’s arm, and Pam rubbed her back. I waited for a minute, for Pam to climb in her recliner and let me start her IV. It was quiet again; a few patients came in and sat in the chairs along the wall, waiting their turn. No one seemed to notice the tears.
It was difficult for Sybil, who had talked to her sister at least weekly for years, and had thought of her almost as a mother figure. It was difficult for Pam, whose husband was taking hormone therapy and seeing his own doctor at another hospital. It was difficult for everyone, but it was the most difficult on the last day of their treatment.