COMFORT

I was with a severely anxious young patient the other day. She was doing her very best to be positive and strong, but her cancer had come back. It was spreading to new areas. She was at our hospital to have a portacath placed into her chest ( a sort of a mainline to the heart area) so she could start chemotherapy. This patient had really thought she was cured for life, after two years with no symptoms. She had come to this country as a young and hopeful bride, but her husband had left her, and her family was in another country, so she just had a friend from church to accompany her for this procedure. It was very sad. Imagine going through something like cancer treatment or end of life in a foreign place without any family.

As usual, we had quite a bit of waiting time. Not being able to talk about her medical care, we just chatted as medical interpreters do about everyday things. I noticed that if we joked, her laughter was a big relief to her. So we kept telling stories that put a smile on her face, and the time went by. As staff joined us, we got them engaged in a bit of play as well. Her face lit up when the nurse asked if he could “borrow” her arm to put the blood pressure cuff on, and she jokingly said, “Okay, but only if I can have it back!” She meant her arm, but he understood she was talking about the blood pressure cuff. So he told her she could keep it, because otherwise they were just going to throw it away at the end of the case. When he found out he was saying they were going to throw away her arm, he was like, oh, no, no no!! And the nurse and the patient and the friend were all giggling. It broke the ice.

Once in the procedure room, our nurse started bantering with the surgical nurse and I kept a running interpretation of everything they were saying. The patient could hear how relaxed they were. How confident they felt about doing the procedure. Everyone was being so kind to her. Everyone was attentive and encouraging. Was she cold? Did she want another blanket? What kind of music did she like? They had thousands of artists. She could choose any music style or band, no problem. Was her pillow okay? Was her head comfortable? Did she have any questions? This shouldn’t take too long. This was going to be fine. We do these all day long. Let us know if you feel any discomfort; we can always give you more numbing medicine or sedation. You just let us know.

Everyone was professional, but also clearly knew each other well. At one point during the preparation, our nurse finished a simple task the surgical nurse was supposed to handle, like bringing out a drape, while she had stepped out. When she came back, our nurse told her, “Hey, my back is hurting!” The other nurse asked why, and he said, “From carrying your weight around here!” They kept bantering, all of which I was interpreting, and then our nurse explained to the patient, “She acts like my baby sister – so irritating! But she’s a good nurse!” The patient smiled, even on the table in the procedure room, even being prepared for a portacath, even being shot with lidocaine to numb the area, even feeling some of it. Even with the dread of recurring cancer. A moment of levity. And comfort.

I remember when I was having my first baby. It was taking longer and was much more painful than I had expected, even going into it knowing I would not have any pain medications. At some point, the two midwives stepped out of the room for a break, and I could hear them chatting and having tea in the other room. It was so soothing. I felt sure that everything must be going great if they were able to leave the room and relax. Seeing that they were not worried about me was comforting. Of course leaving the room is not always appropriate, and neither is humor, but when there is something we can do to ease the tension and the fear, to lower the stress level, as our patients face these trying and painful situations, it is so worthwhile.

Seeing this patient comfortable and even happy as she waited for a procedure none of us want to have was a sweet moment for all of us. Laughing together with the nurse before we went into the procedure was clearly a relief to her. And the staff kept her cheerful even in the procedure room. The smile was still gently on her face as she drifted off to sleep.

Helping someone feel safe and well cared for under these conditions, allowing for some comfort even where there may not be a cure – these are too often overlooked in the rushed, high-tech cutting edge science model of healthcare. But it is vital to remember that underneath every hospital blanket is a real person having an emotional as well as a physical experience, in that utterly lonely space of dealing with their unique body’s failings and looming mortality. Reaching out to make sure they feel seen and cared for is what makes them realize they are not alone. And that, my friends, is healthcare at its finest.