When I meet patients on their cancer journey, they may be at the very beginning, middle or end of their illness. Inherent to that is also the other illnesses they come with. Over the years, I have met numerous patients who have also struggled with a severe mental illness.
Our conversations may be related to specific symptoms they are experiencing from their cancer, but are also composites of years with the ups and downs of their mental illness experience. As a palliative care nurse, I’ve had the privilege of learning about the most tumultuous moments in a patient’s lived experiences. These clinical experiences with patients who are impacted by a severe mental illness also provides me with a unique lens to see and understand how they approach their end of life, and how I can best help them navigate that transition.
Just Hang in There
She struggles thirty-years with her
mind,
a daily battle.
She keeps hoping, even with
this last insult to her body.
Ovarian Cancer!
Samantha lays there,
old in her schizophrenia,
new in her cancer.
A distended abdomen,
ordered NPO and an NG tube
decompressing her stomach.
An old memory is shared,
when she was admitted to a psych ward.
At 60 years of age,
planted among strangers,
forced to mix,
and countless medication trials.
At times, drowsy, fatigued,
and in a never-ending fog.
She asked, “will this ever improve”?
They answered, “give it time,
you won’t be here long.
Just hang in there!”
She held their words tight in her
bosom.
Like a mothers soothing lullaby.
Whispering repeatedly to herself,
J-u-s-t h-a-n-g i-n t-h-e-r-e!
“Why did I bother”, she utters,
“I was just told I’ll likely be dead in a
month”.
Imaging confirmed – a complete
unresectable bowel obstruction”.
All too often nurses witness families’ struggles with medical decisions even when their loved one is close to endof- life. Fear of the dying process is also common. Nonetheless, death is a natural part of life and among those who face it, death is something to be deferred.
Family Dilemma
A family that gathered
united and once whole.
Until cancer knocked on their door.
Metastatic breast cancer
to the brain.
Previously radiant
and now bed bound.
Minimally responsive.
Whole brain radiation
and a chemotherapy clinical trial;
only used by two others,
with no meaningful success.
However,
hope still prevails.
The fight for life
at all cost.
While the nurse recognizes
her death awaits
steps ahead.