I Sing the Song Because I Know the Composer

It’s like I was never gone. I have slipped back into my work life seamlessly, with hardly a hiccup. This week has passed by at the speed of sound, leaving me almost gasping for breath.

Monday was so hard.  Dr. B had been gone the previous week, and was leaving Wednesday on another of his whirlwind trips, so his schedule was loaded. He is the kingpin, the medical director, the world-famous myeloma doctor that most everyone comes there to see. His schedule is always loaded, but it was extra-heavy this week.  With one nurse on National Guard duty, one on vacation, one on sick leave and one just on her day off, that left only five of us to care for 60 patients. No matter how you slice and dice it, that is still twelve patients each.

Twelve patients with cancer. Twelve patients who have needs and concerns and deserve the very best we have to offer. There is not enough of me to go around. I literally ran from one to the next, praying breathlessly in between, that my mind would be clear and focused, and that I would be accurate in what I did. I did what needed to be done for each one, throwing the chart on my desk to be dealt with later, and moving on to the next.  The day was a blur of chemo orders and phone calls and prescriptions. I don’t remember eating the lunch I had packed that morning, but as I gathered up my things at the end of the day I found the crumpled wax paper wrap under the avalance of papers on my desk.

Cherie and I left at 8:30 that night, walking wearily to the parking lot in the chilly air. Tomorrow will be better, we promised each other as we parted; I waved at her as she turned south and I headed north in the darkness. Fifty minutes later I was turning into my driveway, where Chuck had supper waiting for me. By 11pm I had eaten supper, showered, and was falling exhaustedly into bed. Within 4 hours my alarm clock was ringing and I was getting up to do it all over again.

Tuesday was no better. One nurse was back, another was off. We still ended up with twelve patients each. When you consider that four or five patients is a full day if done correctly, twelve is scary. It was another day of running, trying to give everyone what they needed but having to cut corners. The patients were cranky and tired of waiting. Cherie has threatened to get a T-shirt that says "Sorry. I was with another patient." She says it will save her having to say it a million times a day.

 One of my patients actually left and was halfway home by the time I located him. He was starting chemo the next morning and there were still lots of pieces of information he didn’t have, nor had he signed his consent.  *sigh* Now I had to write everything out, and leave it for one of my coworkers to take care of the next morning, because it was my off day.

And because I was off the next day, that meant I had to stay over and get everything finished; I couldn’t play catch-up the next morning, because I wouldn’t be there. My last patient was gone by 6:45 and I sat down at my littered desk to try to make sense of the jumble of charts and papers lying there.

Fortifying myself with a cup of black coffee, I just chose a chart at random and started. The doctors order lab tests by the hundreds; each one of them must be entered into the computer separately, along with all the assorted PET scans, MRI’s and CT scans. New medicines have to entered into each patient’s chart, and either sent to our pharmacy by computer or called to their preferred pharmacy. Each set of orders must be copied in duplicate and the originals signed in to a scheduler, who schedules the tests and the next appointment. All five of us stayed over, and the click-click-click of computer keys was the only sound in the office.

Gradually, the rest of the nurses began to leave. They would all be back the next day, so they left what could be finished in the morning. One by one they drifted out, calling out goodnight to the ones still hard at work. The last nurse left by 8:45, and then it was just me. I refilled my coffee cup and picked up another chart from the pile still left on my desk. The evening housekeeping staff came through,  looking surprised to find someone still there.

They worked around me, emptying the trash and buffing the hallway. I got up briefly to stretch my legs, and a smiling Hispanic woman seized the opportunity to vacuum the crumbs and popcorn from under my desk. I ran up and down the hallway, signing in orders, delivering copies and charts where they belonged, and returning phone calls;  by 10:20 I was down to the final chart on my desk.

I skimmed the orders, entered the lab tests and new medicines, and called in the last prescription. Signing in the orders and delivering the chart to the rack, I heaved a sigh of relief. It was 10:45pm. The housekeepers had finished and moved to another floor; the office was empty, the hallways dark. Gathering up my bag, I snapped off my desklight and clocked out. I had been there since shortly after 6:00 that morning, and I was totally drained. Somehow I had to manage to find the energy to make the drive home.

I stepped out the back door; the rain had stopped and the air was surprisingly cold. The parking lot was deserted, save for my lone little silver car. There was no traffic on the wet street as I crossed; the stoplights were shining red and green for no one in particular. As I walked to my car, I kept my eyes alert and aware of my surroundings. I am not  afraid, but this area is unsavory  and at least one nurse has been mugged here. Unlocking my car, I slid my bag into the back seat and collapsed into the driver’s seat. This day was finished, and I only had to find the strength to make the 40 mile trip home.

An ho

ur later,  I was walking into my own sweet house, safe and sound. Chuck had left the porch light on for me, and had left my supper on the stove. Not wanting to disturb him, I kicked off my shoes and stretched out on the couch, still in my clothes. Within minutes I was asleep, only to awaken again and again as muscle cramps seized my feet and legs. Finally, toward dawn, I fell into a dreamless sleep.

When I awoke, the sun was coming up and Chuck was gone; he had left me a sweet note on the kitchen counter. I made myself a cup of blueberry coffee and sat down to watch the sunrise. Surprisingly, I felt good. I think it is because this is what I was created to do. I was created to be a caregiver, to make things easier for the patients I encounter and to be an advocate for them. Some days are easier and some (like the one I had just finished) are bone-achingly hard. But I don’t cry anymore; I just thank God for the talents and the skills that He has given me. I thank Him that He has provided a place in which I can use those skills to glorify Him.  I walk out every night, filled with the knowledge and assurance that I did my very best. I walk out cancer-free.

My days in that clinic are numbered, literally. I have only 99 more working days, 99 more times to try to get it right. Then that door will close, and another will open. I must finish well; I must complete what I have started, before I am allowed to see what is behind the next door. So, this is where I am, just this side of winter. Being about my Father’s business, and doing what I have been called to do. Although I look forward to the next chapter of my life, I will enjoy these last few days, sipping them slowly as I watch the seasons change.

We are one day closer, my friends.