Wednesday, March 11, 2009

news

sometimes it's simple:
your insurance just approved this treatment
your cultures are negative
your x-ray is clear

then there's the other kind. the kind that changes everything.
and as the nurse, you know.

you know the result because you've been checking for it compulsively

you know the doctor told her he would call her today with the result

you know at this moment that she is trying to casually fill the minutes of her life until he calls, checking occasionally to be sure that the phone is working, and that the ringer is on

you know that at this moment that doctor is skiing on another continent and won't be calling

you know you have to call

calling with bad news strips you of all the tools you need to humanize it. you can't lock eyes or lay a hand on a shoulder or hand a tissue. words are all you have and they are just usually not enough.

that feeling...that feeling of dialing, slowly, wishing you could be doing just about anything else, quickly sorting through in your mind what to say and how to say it, knowing your tone will be read in the first hello, knowing this call will be remembered, knowing you just have to spit it out. ugh.

it starts out well and you say hello, and state the facts , and tell her how sorry you are. all too often you then decompensate into some adrenaline-mediated mish-mash of apology or silver lining or offer of hope intended to soften the blow. it's really hard not to even though you both know the score. it's hard. it's hard to demoralize someone. it's hard to know that their life has just changed course down a path they never wanted to be on. it's hard to know that whatever we did didn't help.

after a few quesions, she'll say, 'thank you for letting me know'. and you'll say 'you're welcome', as dumb as that sounds.

soon enough it's over and you're moving on to the next chart, the next note, the next patient, the next call.

at the same moment, she's making calls too - to the people who love her and she's saying, 'the nurse called. it's not good news'.