thanks

i'm sure every year i write about it - about the beautiful hideousness that is oncology at the holidays. in the past, i'm sure i've used words like poignant. this year i think i'll use sucks - infinitely less poetic, but oh so accurate.

when your well-meaning spouse and kids say 'tell me about your day', you'll think with equal parts truth and cynicism you don't mean that. because here's the thing - i really don't have the words...and if i find them - watch out - you seriously might regret asking.

but they'll keep asking and the patients that occupy much of your time and your mental space will become known to your family on some level:

'mom, how's your surfer doing?' - he's hanging in there
'how's the gardener?' - she's doing great
'how's the young mom?' - she's not doing so well

watching the young mom process and navigate her impending death will occupy more than a little of your mental space. she'll ask your opinion about celebrating christmas early, and laugh at the potential awkwardness if she does that...and is still alive when christmas comes. she'll cry and laugh as she plans out her kids' 'best worst christmas ever'. she'll force you into conversations you're not sure you're ready or qualified to have and you'll walk away from them a better nurse. she'll have a love/hate relationship with your honesty, but she'll keep coming back for more.

families - lots of them - will be conscious of this being the last trick or treating, the last thanksgiving, the last christmas. the air feels charged with the extra vivid and sharp emotions that come with this. amid the heavy hearts and impending sadness, hope will still live and even thrive, sometimes. hope that the new drug might be a silver bullet, that he might be 'the one' to respond to the experimental therapy. they'll end your meeting with the words, 'miracles still happen, don't they?'. you'll treat that as rhetorical and hope that's how they meant it because for sure you are not in the business of miracle management - that is another department altogether.

there will be deaths that catch you off guard, conversations that break your heart, tears shared with colleagues, treatment plans altered with hopes of helping someone make it to the next holiday, unexplained joy, entirely too much chocolate, and a partridge in a pear tree. it will leave a girl like you a little dizzy some days.

in the days after 9/11, bruce springsteen wrote a song about the firefighters that entered burning buildings trying to save people. its refrain becomes the soundtrack for this time of year. it explains how, in the face of sadness and suffering, i may feel sad, but i always feel full:

may your strength give us strength
may your faith give us faith
may your hope give us hope
may your love give us love

i am deeply thankful for the patients i have cared for this year and for all they have brought to my life. thankful for the families that have trusted and confided and taught so much about courage and grace and love. thankful to serve with smart, loving, gifted colleagues.

strength, faith, hope, and love from and for all the surfers and gardeners and young moms out there...

thank you