His hands were gnarled and rough, testimony to the long and hard days of toil on the farm. I gripped one, and gently shaking it, introduced myself. At 90 years of age, Norman* said he had lived a good life. Lying in the hospital in a bleak and helpless state, his dry humor alleviated the heavy reality of his situation, if only for brief seconds.
Only 8 days ago, Norman was seen at his local hospital for a check-up, and all seemed fine. After developing weakness and shortness of breath, he was taken to the ED and regular labs were completed (CBC, basic chemistry panel). With an elevated serum creatinine of 2.4mg/dl (0.8 – 1.3), Norman was in acute renal failure and had a serum uric acid level of 14.2mg/dl (3 – 7.5). His WBC was almost four times the upper limit of normal, with the presence of immature blasts. These findings were indicative of a hematological malignancy and tumor lysis syndrome.
To confirm the cancer diagnosis and reveal its histology, a bone marrow biopsy was necessary. I was given the opportunity to watch. Fighting back tears, I watched as the nurse helped move Norman onto his stomach and pulled down his pants. To see such a gruff man, so strong, robust and healthy for most of his life, in such a state, reliant on so many to complete simple tasks, was both heartbreaking and humbling. It had been a long time since I had been significantly reminded of life’s brevity, and with that, the urgent desire to not waste what precious time God has given me. At the risk of sounding morbid, death is right around the corner for all of us, with only differing distances between us and the said metaphorical corner.
I wondered then, and still do, if Norman knew Jesus, if he had heard and understood the gospel. I wondered if Norman feared death, or if he had the peace, hope and comfort from knowing Jesus intimately – from trusting and experiencing the grace through which his sins were forgiven by the blood of the spotless Lamb, willingly shed on the cross. I wanted badly to talk with him, but didn’t know what I would say. I wanted to offer hope, but the only real hope I have is Jesus. I never had the chance to speak with him one-on-one. Even if I had, though, I fear I honestly would have been too scared to broach the subject. I really want to grow in my ability to communicate to others the grace I experience from Jesus, the price which was paid for my sin and the freedom and life Jesus gives. I pray the Lord will continue to work in my heart in this area.
Norman continued to crack jokes whenever possible throughout the procedure, but I couldn’t laugh, for fear that any sound out of my mouth would result in a half-laugh/half-sob. Afterwards, the doctor explained they would have a better idea of what they were dealing with once they received the results from the examination. I knew it wasn’t good, and Norman did too. “If it’s cancer,” he said gruffly, “Good-bye.” He went on to express his confusion in how this all came about so quickly, wondering why they didn’t see anything abnormal at his most recent check-up, only days ago. Though he tried to sound tough and unphased, his eyes gave him away. Widowed, I wondered if he had any children or other family members to be with him during this time. I just wanted to sit with him for a while, to just be there. I remember walking out into the hall, wondering what hope there was on this floor, full of oncology patients, most terminally ill. It was going to be a long, sobering 5 weeks.
When I returned to work on Monday, I was looking forward to seeing Norman again, only to find he had been discharged. I was confused as to the quick turnaround – he had just been admitted! I checked his chart, finding the biopsy results documented. The flow cytometry revealed mantle cell lymphoma, a rare but aggressive type of Non-Hodgkin’s Lymphoma, associated with the worst 5-year survival rate of all NHLs. His prognosis was very poor. Norman did not want to be treated and was transferred to hospice, explaining his short inpatient stay. Even now, 3 weeks later, my heart still aches when I think about his story.
This rotation has not been my favorite, to say the very least. I hated it the first 2 weeks, and on several days sporadically during weeks 3 and 4. I can’t even give you a reason as to why – none that would make you agree and exclaim, “Wow, that sounds horrible!” It’s just not a good fit for me, partially because I’m by myself most of the day with little patient (or any other) interaction. I remember one day in particular I came home really discouraged. Upon confiding in Jeremy my thoughts and feelings, he reminded me that God is sovereign over this, that I was placed here for a specific reason. What that is I’m still not sure, but maybe it’s partly for the realization of the brevity of our time here and the urgency that’s needed in proclaiming the gospel and sharing with others the love of Christ. I need to see the urgent need and feel its weight. I need to identify with it, to be pressed by it. I don’t know, I am not sure why I am here for this rotation at this time of the year, and I don’t know when or if I will ever know. But I believe what Jeremy said is true – God loves me and knows what is best for me. He ordained these 5 weeks for me long before I came into existence. I can rest assured knowing he has his purpose in it. Our God is so good. Praise his name!
"And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Romans 8:28
*Name changed to protect confidentiality
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