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A Promise for Keeping (standard:romance, 10294 words) | |||
Author: Mick@Nite | Added: Apr 27 2003 | Views/Reads: 4135/2476 | Story vote: 0.00 (0 votes) |
Is love enough to keep a promise alive? | |||
Click here to read the first 75 lines of the story viable blood cells left to carry oxygen, fight infection or clot their blood. For months following treatment, the patient is supported with countless life saving blood and platelet transfusions and covered with an arsenal of antibiotics until their body slowly begins producing fresh bone marrow and still then, it is merely a fifty/fifty chance that the new marrow will not also be diseased. If all this were not bad enough, just to mock the patient further, chemotherapy ravages the lining of the gastrointestinal tract causing severe nausea and vomiting, and as an encore - one final insult - chemotherapy exterminates the hair follicles, branding the offended with baldness, identifying him or her to the rest of the world a leukemic. If leukemia is a holocaust then chemotherapy may very well be its concentration camp. Unseen by her, this was the future that awaited Alison Lumm as she was admitted to 6 North to receive what is known as ‘induction chemotherapy'- a fourteen day attack on her infested bone marrow. With crisp white linen, spotless uniforms and colorful floral paintings on her walls, 6 North is a cunning deceiver; misleading her guests upon first impression to the miseries she is capable of bestowing. Alison would not be my patient that day but I watched with much curiosity as she was orientated to our unit by my nurse manager. She was a very pretty but diminutive girl, looking more like a teen-ager than the 26-year-old woman she actually was. But what made her look even smaller was the giant that accompanied her - a huge man with dark features and unsettling eyes. As she was shown to her room, my heart felt for this young woman, knowing what dreadful roads lie ahead, what unpleasantness awaited. As for her enormous companion, something about him left me feeling uneasy, concerned. “Who's your new patient?” I asked the doctor who was writing her chemo orders. “Her name is Alison Lumm,” she said as I took a look at what she was writing. “Ara-c, continuous IV,” I read over her shoulder. “Leukemic, huh?” “Yeah, I just diagnosed her.” “She looks young. Who's King Kong there with her?” “Her husband,” she replied. She barely looks old enough to have a prom date, I thought, returning to my work but still keeping an element of my attention tuned to the new young leukemic, Alison Lumm, and her monstrous husband. From within her room, I could hear voices, mostly that of the nurse manager, but occasionally, a low gruff tone I knew could only belong to her husband. “Is this going to take much longer?” he asked. Jeeze buddy, your wife was just diagnosed with leukemia. My manager explained to him how his wife could be here for some time, as she was very sick. “I mean right now,” he clarified. “I'd like to go have a smoke.” Something about this Goliath had troubled me and he was quickly validating my assessment. Always the tactful practitioner, my manager suggested he go do whatever it was he needed and she would finish up with his wife alone. He simply said “Great,” telling his wife that he would call her later in the day to see how she was. I heard what sounded like a small kiss and before I could look up to get out of the way, he burst from the room, plowing directly into me, sending me down to the hard tile floor. “Excuse me,” he said, not really meaning it by his tone but extending an extra large hand to help me up anyway. Up close, he was even larger than I had originally perceived. With jet-black hair, full thick beard and rugged features, he was not very handsome but more ape like in appearance. His neck was thick, like a fire hydrant, his body a bulky mass. He stunk of cigarette smoke and contempt. “No problem,” I said, rising to my feet, reaching only as high as his chest. Watching him lumber off the unit, I anticipated that he would not make his wife's lengthy and complicated treatment any easier. My day became quite busy following his departure and attention was soon required back to where it belonged, with my patients. I neither saw nor heard of Alison Lumm the rest of that day except for once, when I passed her room to notice her standing at the window, admiring the picturesque view the hospital has of Long Island Sound. Stripped of her clothing and wearing nothing more than a green hospital gown, the transformation from civilian to cancer patient had already begun. Her wavy hair was an exquisite shade of auburn and it glistened in the dazzling afternoon sunlight that was streaming brilliantly through her window. Soon she will lose that too, I thought watching (possibly admiring) her. As I was about to walk away, she saw me and offered the sweetest of smiles. Embarrassed at being caught, I smiled back, only for a moment, before returning my work and thinking about that lovely smile for the rest of the day. Off for the next few days, upon returning to work to begin a long string of night shifts, I was a bit disappointed, I confess, to not find the name Lumm on my assignment. Alison was instead under the care of my colleague Maria and during that unusually slow night, I inquired about our newest patient. “She is doing well,” Maria told me. “Tolerating her chemo so far. She is a tiny little thing, barely says a word. And have you seen her husband?” “No,” I lied. “What about him?” “He is a giant compared to her. And not very nice from what I hear.” “What do you mean?” I asked, very interested in her answer. She proceeded to tell me about how another nurse had caught him giving his wife a hard time about being sick and in the hospital because it was going to ‘infringe too much' on his life. “Well, I'm sure this is hard on him also,” I said. “No Eric, the jerk was talking about her not being around to make his dinner and wash his clothes and stuff like that,” she explained as a call bell rang, sending her off to a patient's room. Five a.m. is blood work time on 6 North and it is the night nurses responsibility to draw their patients' morning labs so the results will be available when the doctors begin filing onto the unit to see their inpatients before rushing off to their offices. Most oncology patients have what are called central lines, larger, sturdier and longer lasting IV's than the small peripheral ones most hospitalized patients receive. Cancer patients, especially leukemics, require these lines for the highly corrosive chemotherapies they receive for weeks at a time. These catheters are also useful for drawing blood, saving the patient from never-ending, and sometimes harmful, needle sticks. Maria was busy getting ready for her blood draws when I offered my assistance. I had purposely drawn all of mine early hoping that she would need help; she accepted my offer eagerly. “Okay,” I said. “I'll do Mr. Collins, Mr. Buttone and, um how about the new girl, Lumm.” “Great,” Maria replied. “Collins and Buttone both have PICCs,” (a type of central line) “and Lumm has a Hickman.” Hickman catheters are the most common type of central line our hospital uses for leukemics and, unfortunately for them, is also the most cumbersome of the lot. Inserted by a surgeon, the tip rests within a large vein directly above the heart and the tubing is then tunneled under the skin until it exits the body just below the right breast where the double-ended catheter simply dangles over the stomach. I have listened to more than my share of patient complaints regarding a bothersome Hickman's lack of practicality and attractiveness. I readied my equipment and saw Maria's other two patients before knocking softy on Alison's door. Not hearing a response, I entered her room in silence, finding her still asleep. Through her window, the early morning sun had spilled across her face encircling it like a halo; quite fitting as I observed how angelic her appearance was upon seeing her up close for the first time. Her complexion was fair and her features light. Her pale skin, nearly translucent, was adorned with small purple spots known as petechiae, a classic symptom of leukemia. Her pink lips were small and delicate looking, like the petals of a fragile flower. I approached her bed and knelt by her side, gently rubbing her warm shoulder. “Mrs. Lumm?” Her eyes slowly opened and for the first time of many, I would be the first person she would see to start her day. “Mrs. Lumm, my name is Eric. I'm a nurse here on the floor. How did you sleep?” “Okay, thank you,” her voice was sleepy and soft. “How was your night?” Terribly polite, it was not often that a patient asked me how my night had gone. “Better than Maria's,” I replied. “That's why I'm helping her out with her morning blood work. Is that ok with you?” “Sure,” she said rubbing her tired eyes. She lifted her head from her pillow, leaving behind the splash of sunlight and, already, a few stray clumps of auburn hair. When she turned and noticed, a worried look seized her pretty face. Having seen that look many times before, I leaned forward, pointing to the large bald spot that had been growing steadily on the top of my head since my late twenties. “See this?” I asked looking up. “Yours is going to grow back someday. Mine? I'm stuck like this forever.” This brought a smile to her sleepy face; the same refreshing one I had admired the day she arrived on the unit. “And with a smile like that,” I added. “No one will even notice that you don't have any hair.” Her smile grew brighter yet and, already assimilated to our routines, she lifted her gown just enough for me to access her Hickman. As I flushed the line to begin drawing her blood, she spoke gently. “Brian hates it.” “Brain?” I asked. “My husband. He hates it. He says it looks ugly.” “What? Your Hickman?” “Yes. He told me it makes me look like a cyborg.” “Well, let me tell you,” I said, finishing my blood draw and hooking her back up to the chemo, “I don't know how many Hickman's your husband has seen in his days, but I've seen hundreds and I have to admit, yours is awfully cute. Have you named it yet?” “The catheter?” “Sure. It's yours now. Kind of like a dog that follows you home. You have to call it something.” She looked down to her Hickman then back to me. “I don't know. What do you think?” I held the double lumen in my gloved hand and studied it intently with an exaggerated expression on my face. “Harry,” I replied. “Definitely Harry.” “Harry the Hickman?” she laughed. “Yep,” I said, snapping my gloves from my hands and dropping them in the trash. “Harry it is.” “Thank you Eric,” she said as that delightfully contagious smile once again graced her small, lovely face. “You are entirely welcome.” I replied, collecting my belongings and making my way to the door. “Is there anything else I can do for you?” “Draw my blood again sometime?” she asked. “Your Hickman and I are on a first name basis, how can I possibly say no,” I replied. “It was a pleasure meeting you Mrs. Lumm.” “Alison, please,” she replied. “Now we're all on a first name basis,” I smiled. “I hope you have a wonderful day. Alison!” She waved, beaming the same captivating smile that still haunts me to this day. For the next three mornings, I would draw Alison's blood, each time, learning a little more about her. She told me of her childhood in rural Indiana, growing up poor on her family's small farm and how the only thing that saved her from continuing the family legacy of toil and dearth was ambition, a love of the English language and a full scholarship to NYU. Upon graduating, she remained in Manhattan, using her degree in English to find work as a copywriter for a major financial publication. Alison had embraced the big city but was seduced away by the large imposing man she had met at a company function. In stark contrast to her background, Brian had come from wealth and privilege and was 13 years her senior. Alison left Manhattan shortly after they met, becoming one of the masses who leave the Connecticut suburbs every morning to work by train. The unlikely pair were wed five months after and it was at Brian's insistence that she left her job in the city to take one with less pay, but closer to home. When speaking of Brian, she would often lose eye contact, her gaze drifting elsewhere. “You seem sad when you talk about him,” I offered one morning. “He was my first love. He swept me off my feet and all I ever seem to do is let him down.” Such was Alison, so full of inner simplistic beauty yet so lacking in self-esteem, always putting others requirements before her own. “Also,” she added honestly. “He doesn't like you very much.” “Gee. I usually have to lay a couple of my bad jokes on people before they start disliking me. Besides, he and I have never really met.” “I told him about you. And about Harry here as well,” she said lightly tugging her Hickman. “He said naming it was stupid and that he doesn't like the idea of another man taking care of me either.” “You tell him, I am a nurse first. That whole ‘being a man' stuff, that's all secondary.” She smiled. “You also tell him,” I added in all seriousness, “that he is going to have to live with playing second fiddle for a while. You have a long road ahead of you Kiddo. Believe me, I know. And there is nothing selfish about taking care of your needs and yourself right now. Do you understand?” She nodded. “Just don't tell him I put you up to it, okay?” joking again. “I've seen him and I don't need that giant after me.” Leaving that morning, I told her that I would not be in for a few days but when I returned, I was hoping she would be part of my assignment and that I would be able to do more for her than just draw her blood. “You are doing more,” she replied. “You're being my friend.” When I returned to work, I was pleasantly surprised to find that Alison had in fact been assigned to my care. Upon entering her room, I found her appearance – even after such a brief period of time - already beginning to change. Her skin was much paler than before, riddled not only with petechiae, but angry purple bruises as well. Her auburn hair was losing its sheen; exposed areas of chalky skin already visible behind her thinning curls. An emesis basin in her lap, I had been informed by the nurse before me that Alison had been up most of the night, retching and nauseated. The chemo had begun waging its internal war against her contaminated bone marrow, the rest of her body, collateral damage. She managed a faint smile upon seeing me. “This is where it gets real hard Kiddo,” I told her honestly. “This is where you have to get tough.” “Get tough?” she said. “I've never felt weaker in my life.” “In here,” I said, pointing to my heart. “And when you feel you don't have any left, you let me know and I'll give you some of mine.” When I informed her that I was going to be her nurse that day, she confessed to asking to be put on my assignment. I told her I was delighted she had. As I began taking her vital signs, she asked, “Eric, when am I going to start feeling better?” “Oh, Alison,” I admitted as I took her blood pressure, feeling her thin arm against mine, “First, it is going to get much worse.” And as I told her it would, Alison's physical condition continued to deteriorate. When I began working on 6 North, a veteran oncology nurse had told me that in order to cure a leukemic, we had to practically kill them first. She was not exaggerating. Over the next two weeks, all of Alison's blood counts would drop to precariously low levels and the nausea and vomiting had become so relentless that she was unable to tolerate even the smallest amounts of nutrition. Daily transfusions of donated blood and platelets became her way of life. She was placed on protective isolation and all visitors to her room were required to wear masks and gowns to defend her from even to most common of bacteria. When she began to spike fevers, IV antibiotics were added to assist her depleted immune system in fighting off any invading organisms. In order to avert malnutrition, she was fed intravenously, but still, the vomiting came in agonizing, unbearable waves. Despite this misery, I never once heard her complain but I could feel her heartache nonetheless. Brian's visits were few but she would always have an excuse for him; “he is busy with work” or “he does not like seeing me this way.” I did my best to support her through this terribly difficult time with a carefully blended mixture of humor and moral support. With each shift I cared for her, this frail sick girl - who somehow managed through all the gloom to furnish me with at least one breathtaking smile a day - would become more and more dear to me. Finally, on the fourteenth day, the induction chemo was complete. The full throttle assault against her bone marrow would conclude and the long period of waiting for her body to recover would commence. Slowly, her blood counts would return to safer levels and by day twenty-two, transfusions were no longer required and the isolation precautions were lifted. During that time she had received nine blood transfusions, eleven units of platelets, had cultured positive for a urinary, as well as a double ear infection and had been on no less than four different antibiotics. I had told Alison that when her nausea subsided and she could once again tolerate solid food, I would prepare for her whatever meal she desired. She chose melon of all things and on the twenty-seventh day of her prolonged visit to 6 North, the two of us feasted upon fresh honeydew, tangy cantaloupe and succulent watermelon, seeds and all. By now, her scalp was completely devoid of hair - short of a few lonely auburn curls - and she had taken to wearing a floppy purple beret that made her tiny head appear even smaller than it actually was. “How long until they know whether or not I'm in remission Eric?” she asked as I cleaned up the skeletal rinds of our all-melon dinner. “That is a hard question to answer Kiddo. Everybody is different.” I explained to her how in a week or two she would be started on daily infusions of what is known as ‘maintenance chemo' - less potent doses of chemotherapeutic agents that were intended to keep her regrowing bone marrow in check and free of malignant cells. “In time,” I continued, “the doctor will do another bone marrow biopsy and if all she finds are healthy cells, you my friend, will be in remission.” “What if she doesn't?” “Hey, right now let's worry about getting you well enough to get the hell out of this hospital and back home where you belong. You have been in here so long, this stale hospital air is starting to stunt your growth.” “Yeah, that and about two weeks worth of high test Ara-C.” I laughed. “You've been hanging around me too long.” On the thirty-third day of her admission, Alison's doctor cleared her for discharge. With the exception of her first few days on the unit, I had been her nurse every shift I had worked. In two days she would begin daily maintenance chemo as an outpatient in the hospitals cancer center on the first floor. “So, how does it finally feel to get out of this place?” I asked her the morning of her discharge. “Scary,” she confessed. “It's not over yet, is it?” “No,” I confirmed, “but the hard part is done for now. I'm so happy that you're going home, but I have to admit, I'm going to miss you a little.” “Will you be giving me my chemo in the cancer center?” she asked. “No, but I can come down there and visit you.” She smiled, gave me a small kiss on the cheek and handed me a card, which I did not open, but put in my pocket for safekeeping. Shortly thereafter, Brian arrived, the first time I had personally seen him on the unit since the day he barreled into me, sending me to the floor. He said nothing, only went to his wife's room and escorted her off the floor. The other nurses had gathered to say their goodbyes and I watched her step into the elevator from the sanctity of the nurse's station. As the elevator doors closed, stealing her from me, she smiled her wondrous smile one last time and pointed to the card I had stuffed in my pocket. That night, in the solitude of my bed, I opened her note. A tiny card - much like its sender - on the front were two cartoon bears, one helping the other to stand, the words ‘Thank You' in script over them. Inside, she wrote: Dear Eric, I cannot thank you enough for all the wonderful care, encouragement and support you have given me over the past month. I know my stay on 6 North would have been twice as difficult if not for you. I will never forget your kindness and compassion. You are the best!!! With Love, Alison Also enclosed was a slip of paper, an e-mail address on it, with the words keep in touch inscribed underneath. I placed the address on my nightstand and tucked the card into a small cardboard box - one reserved for things special to me- that I keep in my dresser drawer. I visited Alison when I could in the cancer center, but work being as busy as it can, it was rare that I would find enough time to escape to the first floor. She was always thrilled by my visits, rare as they were, and each time I called, she would look a little healthier, a little stronger. We did most of our communicating by e-mail. She said that she was still suffering the occasional bout of nausea and every once and awhile, when her white blood cell count would drop, she would have to wear a mask when out in public, but otherwise, things were going well. She told me she had bought herself a wig, but added that she “took issue with the old adage that blondes have more fun.” According to her, she and Brian were also getting along rather well. He had even promised her that once her cycle of maintenance chemo was completed, he would buy her a plane ticket so she could visit her family in Indiana, whom she had not seen in person since beginning treatment. As nice as his sentiment was, it would have to wait. It was about three in the morning when I received the call from the ER informing me of a patient they were sending up: twenty-six year old female with a history of leukemia, complaining of fever and shaking chills. They did not have to tell me the patient's name. Alison had been doing so well, but after the last dose of chemo, her white cells had again plummeted to a dangerously low level. She had been running low-grade fevers at home and was prescribed oral antibiotics but had awoken shortly before midnight, feeling lousy, with shivers and a temperature of 102. She had driven herself to the hospital. “Why didn't Brian bring you in?” I asked. “He has a big meeting in the morning. I didn't want to wake him up.” Her teeth were chattering. I only shook my head as I settled her into her room. She did not look good at all. Her skin was cool and clammy; the few strands of hair she had left, wet and matted to her pale scalp. Her heart raced. Her blood pressure was so low I could barely auscultate it. “Hello Harry,” I said as I started fluids through her Hickman and hung a dose of IV antibiotic. “Long time no see.” She neither laughed nor smiled. She was very sick. Her eyes where glassy and scared, her fragile body aflame with fever. I continued to settle her, wrapping her trembling body in warm blankets, when she began to worsen before my eyes. Sweat began pouring from her hairless head and she was having trouble staying alert. Her blood pressure bottomed, her temperature spiked to 104. I opened her IV fluids wide and yelled for one of my colleagues to call her doctor. “What should I tell her,” she asked. “Tell her Alison is septic.” Sepsis is a medical term referring to a bacterial contamination of the bloodstream, resulting in a total body infection. Unable to defend itself against these invisible trespassers, Alison's fragile body was rapidly shutting down and she needed to be transferred to the ICU quickly. As we waited for her doctor, I supported Alison with fluids, assurances and even a few silent prayers. The Doctor arrived promptly and together we wheeled Alison up to intensive care. “Are you coming with me Eric,” she asked weakly. “Only for the ride Kiddo, but the ICU nurses will take real good care of you. I'll make sure of it.” Her doctor told her that she would call Brian to let him know she had been transferred to the ICU and the last thing Alison said before drifting off into semi-consciousness was “No, don't wake him up. He has a big meeting in the morning.” Following my shift, I returned to the ICU to see Alison but found her asleep with Brian resting in a chair beside her. The doctor had called despite Alison's objections and he had come. He saw me but said nothing, nor did I approach him. Instead, I checked in with the ICU nurse to see how the rest of Alison's night had gone. Alison was very lucky. Large volumes of fluid and potent vasoactive medications kept her blood pressure within an acceptable range long enough for strong antibiotics to suppress the infection and begin restoring her health. Within five days, Alison was back on 6 North and I was again her nurse. Because her white cells were still very low, she was once again put on isolation but that only lasted three days. Brian had brought in her new blonde wig from home and it became the subject of much banter between the two of us. “I like the purple beret much better,” I confessed. “I'm just so sexy in this thing, you can't stand it!” Brian had also, much to Alison's and my surprise alike, flown her parents in from Indiana to visit her. I was unfortunately off the two days they were in town and did not get to meet them. As her health was improving, the doctor felt the time had come to repeat a bone marrow biopsy and the entire unit held it's collective breath awaiting the results, which would not be available until the following day. Though she had told no one, the day of the biopsy was also her twenty-seventh birthday. “What is this?” she asked as I entered her room that evening. “It looks like a birthday cake to me. A small one, but still a birthday cake.” I had bought a blueberry muffin in the cafeteria and placed an unlit candle in the middle. “How did you know?” “I'm your nurse. I know when the last time you went to the bathroom was. You think I can't look up your birthday.” I sung for her an inspired but out of tune “Happy Birthday” and right before she bit in, I took out a small Polaroid camera we keep at the nurse's station for documenting old ladies' bedsores and yelled, “Smile!” “No, Please,” she protested, but to no avail. “Yes,” I replied. “Now smile or I confiscate the cake.” And she did, that same brilliant, beautiful smile that I had fallen in love with months ago. That night, as I lay in bed staring at that Polaroid, I admitted to myself for the first time that it was more than her smile I had fallen in love with. As I contemplated the precariousness of falling in love with a married woman, I found I felt more threatened, not by Brian, but by her other suitor; the one who loved her from deep within her bones, the one who's jealously was a hundred times as deadly as Brian's, the one who would not relinquish her heart until either he had destroyed her or he, himself, was destroyed. If it came to it, Brian and I could vie for Alison's affection all we wanted, but still, leukemia would have the final say. The following morning, Alison's doctor informed her of the outcome of the biopsy. Upon hearing the results, she burst into tears. The first time I had seen her cry since joining us on 6 North. Her marrow was clean and cancer free - for now. Alison went home two days later; again, Brian picked her up. Before his arrival, she called me into her room. “Thank you again,” she said. “Will we still keep in touch?” “Of course. Just because your not my patient anymore doesn't mean you still aren't my friend.” “You saved my life, you know. When I came back from the ICU that day I would have kissed you if you didn't have to wear that awful mask.” I just blushed, saying nothing as she put her soft hand to my cheek. “How come some lucky woman has not found out about you?” she asked as I slowly melted at the touch of her hand. “Guess I just haven't met the right one yet,” I said, looking down to the floor. She lifted my chin and the two of us looked deeply at one another. As I was about to get completely lost in those soft brown eyes, the moment was stolen from us by an angry voice. “What the hell is this?” Brian demanded angrily. “We were just saying good-bye,” Alison stated. “We were just saying good-bye Brian,” I repeated. “Come on Alison. We've gotta go,” he said as she stood to join him, his angry eyes never breaking from mine. He said not another word, he didn't need to; his eyes said it all. They said, “Danger!” and “Stay away!” They warned, “Your fucking with the wrong jealous husband!” and “Don't even try it, because your gonna lose!” That evening, I made an accord with myself to not permit my feelings for Alison to get the better of our relationship. While I could admit that I had fallen in love with her, I would not allow myself to be an obstacle between her and her husband. It was more than his warning to me; it was also my belief in the sanctity of marriage, regardless of how wrong I knew Brian was for her. As promised, I did continue to correspond with Alison through e-mails however, despite her invitations, I no longer visited her when she made her weekly visits to the cancer center. Still, I would often find myself opening the small cardboard box I kept at my bedside late at night to gaze upon that beautiful smile. During the next thirteen months, Alison would do exceptionally well. Weekly visits to the cancer center soon became monthly check-ups and she was even able to start back at work, if only part time. She told me that Brian was not around much, as he was “always busy with work”, so life for her was quiet and peaceful. This notion made me happy. I had known for some time where she and Brian lived and although it was out of my way, after many months without seeing her in person, I would often find myself driving by their house in the hopes of catching a glimpse. One time, as I rounded the corner before her driveway, I saw a small figure in a familiar looking purple beret walking down the street but dared not stop and continued on my way. While I would have loved nothing more than to see Alison in person, I remembered my oath to myself and was content for now to open my e-mail and find her name gracing my inbox. Her messages told of wonderful happenings during those months; her hair had grown back, she had spent her twenty-eighth birthday in Indiana with her folks. Until, that is, the day her correspondence brought with it some rather unsettling news. At her last check-up, Alison's blood counts had been worrisome and as a result, a third biopsy needed to be performed. Despite months of maintenance chemo and in spite of being in remission for over a year, Alison's bone marrow had begun growing malignant cells once again and the doctor would need to initiate a regime of new drugs immediately. She was admitted to 6 North the next day. I was not scheduled to work but, knowing she was coming in, had signed up for overtime. While I was excited to see her, our reunion was somewhat melancholy. “Hey there Kiddo,” I said with the best smile I could muster. When she saw me, her sad eyes filled with tears and despite my better judgment, I took her tiny body in my arms and held her close. “I'm so scared, Eric. I don't think I can do this again.” I kissed the top of her head, her new hair thinner and curlier but still the bold shade of auburn I had remembered. I helped get her settled and we would again begin at square one, induction chemo. Harry the Hickman long gone – an angry scar across her chest the only evidence of his existence – she now had what is known as a Port-a-Cath; an internal central line that is implanted in the chest wall and accessed through the skin with a hooked needle. I accessed her Port and initiated her first new dose of chemo. Brian had not come with her to the hospital initially, but when he arrived later that evening, he was not at all pleased to find me in Alison's room. My shift had ended over an hour ago and I was there on my own time, catching up on all the particulars she and I had forgotten to mention in e-mail over the past year. “I need to talk to you outside,” he said, addressing me as he entered the room. I told Alison that I should be going anyway and that I would see her tomorrow. She was visibly concerned as her husband and I exited the room together, closing the door behind us. “Why don't you stay away from my wife,” he asked, and not very kindly, as we stood in the hallway outside Alison's room. “Why don't you treat her a little more like a wife?” I responded. “Listen buddy. I don't need you to tell me how to treat Alison. What I need you to do is keep the fuck away from her, understand?” “I'm her nurse Brian,” I said trying to contain my voice, as well as my anger the best I could. “If you're asking me not to take care of Alison anymore, the answer is ‘No'. And if you're asking me not to be her friend, the answer is still ‘No'.” “Listen asshole...” “No, you listen,” I interrupted. “Do you realize how sick Alison is? Do you even comprehend for a second how close she came to dying last year? She doesn't need some jealous thug of a husband that bullies around nurses, she needs one that'll support her and hold her hand every once in a while. Someone who'll give her a little encouragement and think about how she's feeling instead of only worrying about himself and how her illness impacts him. Why don't you try to help her through this for once, rather than making her feel guilty about it?” He just stood there. “You don't seem to be able to do that Brian. So I'm just filling in your void.” At this, he simply shook his square head and pointed a crooked finger my way repeating, “We'll see. We'll see.” The next morning, I arrived at work to find that Alison not part of my assignment. “What's this all about?” I asked my manager in the privacy of her office. “Mrs. Lumm's husband is...” “A jerk,” I interrupted over her words. “Is very concerned,” ignoring my comment, “about your relationship with his wife. He has asked that you no longer care for her.” “He can't do that,” I replied. “True, but I can.” “Why? Why would you want to?” “Because frankly, I agree with him.” I did not respond; I just stared at her in disbelief. “You're getting too close Eric. That's not good,” she rose from her desk and stood beside me. “Look, I am not accusing you of anything. You are one of my best nurses. I know you would never mishandle a nurse-patient relationship, especially with a married patient, but you are simply getting too close.” She returned to her desk before adding, “You know she is out of remission.” “Of course I do,” I said softly. “She is very sick Eric, the odds are not with her. Her prognosis is grim. We see this every day, you know what happens. I do not want to see you get hurt.” I returned to my work, accepting her decision, but once my shift was complete, I went to visit Alison. “I thought you weren't allowed to take care of me anymore?” “They can tell me that I can't be your nurse anymore but they can never stop me from being your friend.” “What about Brian?” “Alison,” I answered with a question of my own, “Do you want to continue being friends?” “Yes,” she said with her sad eyes. “Then it's our decision, no one else's.” We decided then that we would not allow anyone to prevent us from remaining friends. We also agreed, however, that it would not be wise for me to be around when Brian was visiting. That did not matter much though as he was, much like her previous admissions, rarely around. Some nights, I would drive by their house late only find it vacant, cloaked in darkness, his car not in the driveway. Alison's third visit to 6 North was, as expected, much like her first: thinning hair, low blood counts, daily transfusions, nausea, infections. The only thing different was that I was not her nurse. I would check on my friend frequently. On the rare occurrence that Brian was in, the nurse caring for Alison would alert me and I would keep out of his sight. On days we would not get a chance to talk, Alison would often write me brief notes, leaving them with one of the nurses for delivery. At days end, those notes would always find their way into the small cardboard box by my nightstand. One day, four weeks into her stay, I found her sobbing miserably in her room. She was again on isolation and I was cloaked in gown and gloves, a mask concealing my face. Seeing her so sad, I wanted nothing more than to hold her but I knew could, and should, not. “Alison, what is it Hon?” “He's leaving me Eric. He found someone else.” “Who, Brian?” I asked. “What are you talking about?” “He came in today and told me, right here,” she said in a very sad, low voice. “He met a woman at work. He told me he has been seeing her for a year now and that it is all my fault.” “You know that's not true Alison.” “He said that if I had been there to take care of him, it never would have happened. He said he is going to move in with her now and that when I am better, he wants a divorce.” “That is the most cowardly thing I have ever heard. Don't you dare believe him Alison, not for a second.” “He said I'm only sick because I'm not strong like him,” she was just staring blankly out the window. “That is not true, Alison.” Finally, she looked up at me. “I know Eric. I know that now, because of you.” And with that she broke down, the hardest I had seen her cry her entire illness. Before I could stop her, she reached out and placed her small head against my chest, the floppy beret she had resumed wearing falling to the floor. “Make it go away, Eric. Make it all go away.” I caressed her tiny head, hairless once again, with my gloved hand saying nothing, only listening to her heartrending sobs, wishing I could do as she requested, fighting back tears of my own. Things were very different after that. Without Brian around at all, I could now visit Alison whenever I felt and would do so everyday, including my days off. Things were also better in that Alison's health was slowly returning as her bone marrow began recovering from the chemo's deadly assault. Within two weeks, Alison was doing remarkably well. Her spirits were high and with the exception of her platelets, so were her blood counts. Sometimes, when a patient receives as many blood or platelet transfusions as Alison had, the body begins creating antibodies against the foreign cells. Over time, Alison's body had produced so many antibodies to donor platelets that despite how many units we would give her, her counts remained at unsafe levels leaving her blood too thin to clot properly. What this meant to Alison was that even though she was feeling better, she would have to remain with us on 6 North for a few more days until her marrow could produce enough platelets of her own that she would no longer be at risk of bleeding. That was fine with me, and as she was not looking forward to going home to an empty house for the first time, it was OK with Alison as well. We decided to celebrate what we called ‘A few extra days on 6 North' with a pizza party during my dinner break that evening. We enjoyed our pizza but as usual, enjoyed each other's company even more. The sterile gowns were gone and it was nice to be able to sit near her and touch her without a gloved hand. “I'm feeling so much better,” she said as we ate. The color was returning to her face and her eyes did not look nearly as sad. “You look much better,” I replied. “I mean inside,” she said tapping the area above her heart. We sat quietly for sometime and without warning, she reached for my hands. “Promise me, Eric. Promise me I am not going to die.” Rule number one of oncology nursing is to never make promises. Accepting Alison's small hands in mine, I brought them to my chest. Holding them over my heart, I broke that rule. “You are not going to die Alison. I promise.” She smiled with a small tear in her eye and kissed away the one that had fallen down my cheek. I smiled back and kissed her hands. I wanted to tell her right then that I had fallen in love with her and that no matter what, I was willing to see this thing through, but I had already broken one rule of nursing that night and did not feel that this was the time or place to break another. “Hey, I have a shift to finish here,” I said looking at the clock on the wall. I got up to leave but Alison held on to my hand for one extra second and if ever anything were ever going to be said between us, it would have been right then. Before either of us could speak, her door opened and Robin, Alison's nurse for the night, who was beginning a twelve-hour shift, entered the room. I squeezed Alison's hand gently and told her I would stop in after my shift to say goodnight. Robin smiled at me, almost knowingly, as I left the room. By the time my shift was complete, Alison had fallen fast asleep. I did not have the heart to wake her and instead, stood silently at the foot of her bed, admiring her angelic face in the moonlight that shone through the window and I whispered under my breath, in a sort of wishful prayer, that it would not be long until the time would be right for the two of us to be more than just friends. As I punched out, Robin asked if I was working in the morning. I said no but added that she still might see me anyway, as a visitor, and she smiled as I skipped off the unit and onto the elevators. That night, I dreamed of Alison. In my dream, she was anything but sick. Her body was strong and cancer-free, dressed not in a sterile hospital gown but a magnificent evening dress. Flowing and white; it fluttered in the wind behind her like the wings of a butterfly. Her own auburn hair grew freely and it spilled across her shoulders as we ran together, hand in hand, across the sands of some far away beach so breath taking, it could only be envisioned in a dream. We laughed and touched and kissed, unashamed and unafraid of deadly bacteria or jealous husbands. In my dream, we fell to the sand and into each other's arms, her dress spilling open to reveal only her beautiful breasts – free from catheters, clean of surgical scars. I brushed the hair from her lovely face and we kissed as the orange sun fell asleep and the sky was claimed by a brilliant white and full moon. Clothed only in silver moonlight, we made love as warm tropical winds enveloped us like a blanket. “I have fallen in love with you Alison,” I confessed to her in my dream, bringing tears to both of our eyes. “Now, I will never die Eric,” she said as her hand rested gently on my chest, directly over my heart. “Because I will always live here.” Because, I will always live here. I awoke that morning with a renewed sense of urgency. What was I waiting for? Her husband had left her; I was still no longer allowed to care for her. What did I have left to lose? If my love for Alison raised some eyebrows around the hospital, well then to hell with them. I dressed quickly and headed for the hospital. Robin saw and tried to stop me as I made my way to Alison's room, but I was a man who would not be impeded. I entered her room only to find it empty, the walls striped of her pictures and cards, her bed vacant. They couldn't have sent her home already, I thought to myself and before my brain could imagine the only other reason why she would no longer be in her room, I felt a hand on my shoulder and turned around quickly to see Robin before me with tears in her eyes and Alison's purple beret in her hands. “Don't you dare tell me she's dead Robin,” I pleaded. “Don't you dare!” “She's not dead Eric, but she...” Robin looked into my desperate eyes, almost apologizing, “she bled sometime during the night. I found her unresponsive early this morning, barely breathing. I called a code and we saved her, but the CAT scan showed a massive intercranial hemorrhage.” Without enough platelets in her tired body, Alison's blood had become so thin that she spontaneously bled into her brain, sharing the fate of so many leukemics before and after her. Robin wrapped her arms around me but I could not respond. I just stood there, numb, dying. “I'm so sorry. I know how close you were. They brought her to intensive care and they're waiting for her family to arrive before... before they withdraw life-support.” “I love her Robin,” I finally managed weakly, staring out at nothing at all. “I know Eric,” Robin said as she placed Alison's beret into my trembling hands. “And she loves you too.” I looked at her, taken aback. “She told me,” Robin confessed, smiling between her tears. “Last night, after you left. Go be with her Eric. She would have wanted you there.” I rushed up to the intensive care unit on the ninth floor and, out of breath, checked in at the nurses' station where I, even as an employee, had to request authorization before seeing a patient. “There's been a restriction placed on visitors for Mrs. Lumm,” I was told by the nurse on duty. “By who?” I asked confused. “By me.” I turned around to see Brian hulking over me. “What are you doing here?” I asked angrily. “Watching my wife die. What are you doing here?” “I came to go say goodbye to my friend,” I responded as I tried to push my way past him, fighting back the tears that were beginning to fill my eyes. He grabbed me around the shoulder and pulled me back. “No one sees her, except her parents when they get here.” Legally, he had every right to forbid me from seeing her. I could not fight him on that. I tried one final plea. “Please Brian. Please let me say goodbye.” The tears were beginning to flow freely now. Softy I added, “Please, I love her.” This infuriated him and he raised his fist, bringing it down hard on my jaw. I fell to the floor, blood spilling from my mouth. The ICU nurse picked up the phone but I asked her to stop knowing she was about to call security. Brian was standing his ground, fists clenched. I slowly rose to my feet, wiping fresh blood from the corner of my mouth with the back of my hand. I stood no chance against this giant and I was not about to try. That is not what Alison would have wanted. With her in mind, I lifted my hands in surrender. He would win, but I still had something I wanted to say. “You never once realized what you had, did you?” I said backing away. “Get the fuck out of here!” he demanded, fists still raised. “She did love you Brian. And it is so sad that you don't even appreciate what a precious gift that was.” I continued to back away, blood trickling from my mouth, tears falling from my eyes. “I said get the fuck out!” I swallowed hard and was about to turn and leave when I decided there was one more thing he needed to know. “I do love her Brian, and she loves me too. And you can never take that away from me.” He did not respond, he just continued to stare me down with his ugly, hate filled gaze. In time I would learn to feel sorry for him but at that moment the only thing I was capable of feeling was the bitter throbbing of my fractured heart. I turned and walked away. The first door I came to lead to a fire escape stairwell. From nine stories up I began a rapid descent, my sobs and footsteps echoing off the walls, until I lost my footing and fell, my body tumbling through the air before landing hard on a guard rail, dangling over the edge, staring down seven stories of openness. I watched as a drop of blood fell from my mouth and disappeared into the darkness below. For a moment, I saw myself climbing over the guardrail and following that lone drop through the shadows and into the concrete floor that awaited me beneath. What a fitting end to this tragedy, I thought as I hung there halfway between life and death, just as Alison did two floors above me. How fitting that we end like all those celebrated star-crossed lovers that came and suffered before us. And as my legs slowly scaled the guardrail like a condemned man climbing the gallows, I saw Alison in my mind, much like I had in my dream, asking me to stop. I paused and watched as one more trickle of blood fell from my lips and held my breath, counting the seconds - one, two, three, four, five - until it made it's nearly silent splash in the obscurity below. I climbed down from the guardrail, slumping to the stairs, defeated and heartbroken. I sat alone in that cold empty stairwell for almost an hour and wept like I never had before, mourning a life so beautiful, so precious and a love that would never be given a chance to bloom; my pitiful sobs, hushed by a floppy purple beret. Alison's family arrived from Indiana later that evening and life support was withdrawn about an hour after. A fighter to the end, I was told that she held her own, much to the amazement of the ICU nurses, for almost an hour, before her exhausted body could take no more, finally succumbing to the illness that held her prisoner for over two years. Alison Lumm, the tiny girl with the sad eyes and brilliant smile, was freed from leukemia at 8:32 that evening with her parents by her side, about the same time I was sealing the small cardboard box I had filled with seven hand written notes and one floppy purple beret. An ICU nurse told me Brian had been outside having a cigarette at the time of her death. Alison's family brought her body home to Indiana for burial and on the day after her funeral, I received a phone call from her mother. She told me she was contacting all the doctors and nurses who had taken care of her daughter to thank them personally and added that I must have been special because Alison had mentioned my name “more than once or twice”. I told her that “Alison was the special one” and left it at that. She thanked me once more before saying good-bye. Brian moved the rest of his and Alison's belongings from the house they had shared and sold it to an older couple who always say ‘hello' to me when I stand in front of their home longer than is polite. As far as I know, he is still with the woman he left Alison for as I have neither seen nor heard of him since that day in the ICU. Like any wound, mine is slowly healing, but the scar, it will always remain. Not a day goes by that I do not think of the tiny girl with the sad eyes and brilliant smile. Work has, and never will be the same. I unfortunately care for my patients now with a dull sense of empathy, never getting to intimate with them nor letting them get to intimate with me. On a piece of corkboard at the nurse's station, I have hung the Polaroid I took of Alison on the night we celebrated her birthday. When people who do not know of her ask me who the happy girl with the wonderful smile is, I simply say, “That is Alison. Isn't she beautiful?” Some men yearn for just one more day with their lost love. Me, I ache for just one-day period with the woman I never had the opportunity to love. I sometimes wonder what life would be like if Alison had not died. I imagine the two of us on that beautiful sandy beach from my dream, running free and in love, living a lifetime in one perfect day. And when the full moon finally rises and that magnificent day meets its end, I feel Alison's tiny but warm hand on my chest, directly over my slowly healing heart, and I hear her words as if she were still right beside me. “Now I will never die Eric, because I will always live here.” No Alison, you never will die. I made a promise and until the day comes when I breathe no more and we meet again, you will never die because you will live within my heart. Always. ************** For Carrie – I have not forgotten. Tweet
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