Later that day, after checking in on all of my patients and getting my first med pass done, I was able to give Jax a call. I went through everything, and I found that her kidneys were, by lab standards, shutting down. Her body was weak already, but the medications were taking a toll on her kidneys. More tests had to be ran, but she was already recovering the last I’d checked. Chemotherapy was hard. It hurts the body in terrible ways. That kind of effect wasn’t rare, but it was fortunately something that didn’t happen all the time either.
It took a while for me to decide if I should call him from my phone, giving him my number, or if I should use the hospital phone. Since it was a professional reason, I decided to use the hospital phone. When he arrived, he surprised me with a coffee and small box of cupcakes.
“What are these for?” I asked. “You didn’t have to do this.”
It was incredibly sweet, but I felt terrible about it. His mother was on the floor above mine, which meant that he’d made a special stop to deliver them.
“I thought you might be hungry,” he said.
“Well… I am. Thank you very much,” I replied with a smile. “But you still didn’t have to do this.”
He shrugged. “You’re busy saving lives and thinking about everyone else. Someone should think of you.”
My mouth fell open slightly. I had no idea how to respond to what was probably the nicest thing anyone had ever said to me.
“Thank you for thinking of me,” I said. How’s your momma?”
“Better. Thanks to you.”
Andi wandered by then. As she passed and Jax’s back was to her, she gave two thumbs up and exaggeratedly mouthed the words, “You go girl!” to me. I did my best to ignore her, but it was difficult with her acting like an idiot.
“I’m glad to hear that she’s doing better,” I said. “Once I told the doc about her labs he was able to make the necessary changes. Is she handling her new medication alright?”
“She is, but I think she’s changing her mind about her course of treatment,” he said.
“Oh?”
“Yesterday she talked to the surgeon about the possibility of doing a mastectomy because the cancer is isolated. He talked to her about reconstruction and all that went into it, but she just didn’t want to. She said that it made her feel like less of a woman. It was only an option if it was the last option. After today, however, I just want her to do it. I want her to do what makes her comfortable, but... she’s my mom. I want her around, too.”
“So, if she isn’t considering a mastectomy and she isn’t wanting to do the meds anymore…” I paused. I couldn’t imagine saying what it sounded like. She was young and otherwise healthy. To just give up… It didn’t sound like the woman that Jax had spoken about earlier.
“She doesn’t want to continue at all,” he said, his eyes turning toward the floor.
I sat the cupcakes down and opened the container. After grabbing two of them, I turned and handed him one.
“First – eat one of these,” I said.
He half-smiled before taking it. We stood in silence as we each ate our impressively delicious cupcakes. They were unbelievable.
“Where did you get these?” I asked. The box was unmarked.
“Lizzy J’s,” he replied.
He’d gone to an actual bakery for those yummies.
“I’ve wanted to go there forever and haven’t. That was the best cupcake of my life. My inner fat kid is loving you right now,” I said.
He laughed. “Good! I’m glad you liked them! That is my favorite place to go.”
“Well, it’s my favorite now as well! And now that you’re smiling, onto phase two,” I said.
“What’s that?” he asked.
“Have you told your mom how you feel about her decision?” I asked.
He sighed. “No. I tried, but I don’t want to upset her.”
“This is a big decision, and it needs to be made quickly, but it also needs to be made correctly. She needs to do what is best for her, not what’s easiest,” I said. “Legally, I can’t influence her decision, but I can help build the bridge to help you both talk. If you’d like, I can do that for you.”
“Please,” he said. “That would mean the world to me. I want her to do what makes her comfortable, but I want to make sure that she’s making the decision that she wants. Not the decision that seems easiest because she’s scared and depressed.”
“It’s okay. Let me get everything tied up here, and I’ll go up with you. I planned to check on her before I left anyway.”
I texted Andi and told her I was heading to the ICU with Jax. She was surprisingly calm and understanding instead of perverted. I grabbed my coffee, that was equally as delicious as the cupcakes, and headed upstairs.
When we arrived to her room, I found myself doing typical nurse things before anything else. Even though she wasn’t my patient for that day, I still checked her vitals, comfort levels, and checked her med times. She was doing much better, for which I was grateful. Her children seemed to need that very badly.
“Hi, Nancy,” I said as I once again made my way to her bed. “How are you feeling?”
“Better,” she replied. Her voice was shallow. It didn’t sound weak; it sounded depressed. “Thank you.”
“I’m glad to hear that,” I said. “Is there anything that I can get or do for you?”
“I’m okay,” she said. “Thank you.”
“You’re welcome.”
Like Jax, I didn’t want to upset her. Approach was key. Casual lead in was always the best option with any conversation. It’s so much easier to bring something up with the topic has been heading there anyway. Obviously, I’m not the most direct person, unless it’s a life or death situation.
“How are the new medications treating you?” I asked. “Are you feeling better or worse?”
“Physically, I’m feeling better,” she said. “The nurse said that I’ve doubled my output from earlier. Given what it was then, it’s still not good, but better is always a nice thing.”
“Physically better, but not emotionally?” I asked.
There was a pause. She sniffed a little, and I decided to use that as my entry. I made my way over to the side of the bed. Without hesitation, I did something I’ve done a hundred times. I reached for her hand and gently held it in my own. Tears streamed down her cheeks.
“To ask what is wrong would be insensitive,” I said. “You’ve been through a lot. From what Jax has told me, you had been through a lot long before this. To add to it… I know that it must feel cruel. Like a sick joke.”
She nodded, sobbing lightly. “Yes,” was all she could manage.
“Even though I know all of those things, and I can understand why you would want to cry, I would like to know which part is overwhelming you right now. You are surrounded by family. You are very safe to express yourself. If you don’t feel that way, because you’ve always been the strong one for them, I would be more than happy to ask them to step out for a moment. Regardless, as a caregiver, I know how much these things weigh on someone. You should be able to vent however you need to. Even if it’s needing someone to scream at because you’re angry. I’m here for that. It won’t hurt my feelings at all, I promise. Whatever it takes to help make those helpless tears go away. Because you aren’t helpless. Your life is in your hands. We proceed as you see fit. You are in control, even at a time in your life when you feel you haven’t even the tiniest grasp of it.”
Her mouth fell slightly open as she looked into my eyes. Her face stilled, and the crying almost immediately stopped, though her eyes were still wet enough to allow another tear to break free. It was obvious that she didn’t expect someone to speak to her like that.
“What is your name, sweetheart?” she asked.
“My name is Elizabeth,” I replied.
Jax cleared his throat, his voice cracking a little as he spoke. “She’s the one I told you about. She’s the one that saved you.”
Nancy gave a sad smile. “You’re very sweet,” she said, taking a deep breath. “And everything you said makes sense, but I don’t feel in control. I’m dying.”
“Not if you don’t want to,” I said.
“How can you know that?” she asked. “Certainly, seemed that way today.”
I took a moment to weigh my words carefully. Not only was it against all rules to make promises about outcomes, it was common sense not to. Still, giving hope was a very important part of the job.
“I can’t promise that you won’t die,” I said bluntly. “I apologize, but I can’t. What I can do is tell you that before this you were very healthy. Very. Your cancer is isolated in one location, which is pretty lucky. You caught it early. This means you have a lot of choices for treatment.”
“No,” she said flatly. “No more.”
“Just hear me out. Just because I say something doesn’t mean it’s written in stone. It doesn’t mean you’re forced to do what I say. It just means that you are well informed,” I said.
“Please, Mom,” Alex said. “Please just hear her out.”
Nancy sighed. “Alright.”
“You are young. You are beautiful. Even sick and on what could have been your deathbed today, you are still beautiful. You have brutal honesty and a fierceness about you that is admirable. What happened to you today was a very bad bump in the road. Very bad. Still, it doesn’t mean that it was the only road. Did your doctor and nurses explain to you exactly what happened?”
She opened her mouth to answer, but her daughter butted in.
“No. They tried, but she was mean to them and told them to leave. She just wanted to be alone. They started talking about treatment and trying to explain everything and she refused to listen,” she said.
I took liberty and sat on the edge of her bed, taking her hand once again.
“You had a severe reaction to the medications that you were on. Your kidneys began shutting down and your potassium levels rose very quickly as a result. Potassium is partly responsible for the electrical activity in your heart. It helps it beat regularly. If there is too much or too little, it can mess up your rhythm. In your case, it caused your heart to fail. Now that the medication has been stopped and they’ve prescribed meds to help, you are having more output. That means that your potassium levels are going to be just fine. This was a very acute and terrible thing that happened, but it’s not a chronic situation.”
“I can’t go through that again,” she said.
“There are many different ways to do treatment. There is never a cookie cutter solution. Everyone is different, and they need different things,” I said.
“You think I should have the mastectomy,” she said flatly.
I shrugged. “I think it’s an option. I can’t tell you what to do or what not to do. All I can do is give you the options and help you decide what you think is best.”
“No. Absolutely not. How would you feel if you didn’t have breasts? If you don’t have children of your own, you may not understand, but God willing, you will one day. They are a part of me. They allowed me to feed my babies. They don’t look like it now, but all three of them were cute, pudgy little things. And yes, I do feel sexier with them. I know it’s probably shocking to think of a woman my age wanting to feel such a way, but we do. You’ll understand that one day as well. Breasts are as much a part of a woman as all the things between a man’s legs. I can’t even imagine it,” Nancy said.
Most people would probably dismiss her as crazy or selfish. She was neither. She was a proud woman who didn’t want to feel ugly and ashamed of herself. To her, surviving cancer only to look at her body in regret and disgust was not an option, but she was panicking and not thinking of the whole picture. It wasn’t uncommon to have happen.
“Mom,” Jax said stepping forward. “You did your job. We are all grown, and we are all very grateful for everything you’ve ever done for us. You don’t have to cling to the very thing that is killing you simply because it was what sustained us when we were babies. We aren’t babies anymore, but you’ll always have the memories of being a mother and everything that entailed. As for the rest… Any man that won’t accept you and looks at you like you are any less than perfect just because of your breasts…” He paused. “Do I really need to finish that? Do you not remember how you beat it into my head? Into Alex’s head? How you taught both of us to respect women and never judge a woman by the shape of her body, but what her personality holds?”
“He’s right, Mom,” his sister said. “How am I supposed to feel? You told me that I am more than a body. Any man or woman, if I was so inclined, that judged me on nothing more than what I looked like was never worth my time. Now you’re saying that it’s okay to allow a disease take you as long as you look good until the end.”
“LeAnn!” Nancy chastised.
LeAnn sighed. “I’m sorry,” she said. “This is just scary, and I’m not used to seeing you like this. I didn’t mean to sound so rude.”
“This is a very scary situation,” I said. “You have every right to feel worried. All of you do. Just remember that you can’t let it come between you. In the end, the decision is hers.”
“It is,” she said, squeezing my hand. “Can you have the surgeons and oncologist come to see me?”
I smiled. “I can. Your oncologist is already scheduled for today because of what happened, but I will call the general and plastic surgeons. Remember. Surgery is not your only option. You have many, and that is just one of them. Listen to all of them and make the one that is right for you.”
“Thank you for saying something. I know you did it for them. It was hell watching them all stare at me, seeing a weakling and being too afraid to say anything,” she said.
“You’re welcome. Sometimes families just need a bit of time to adjust and the conversation just needs to be started. You get some rest. I’m going to head out of here. I’ll check on you tomorrow, okay?”
She nodded and gave my hand one more squeeze as I stood.
“All of you need to try to relax. Go see a movie or something. She’s in good hands and she needs sleep,” I said.
Jax’s eyes never left me as I spoke to him and his siblings. I gave a small smile in his direction before turning to head out. I’d only gotten a few steps out the door when everything spun around me. I very quickly found myself wrapped in warm, strong arms. I knew it was Jax by the color of the shirt. He smelled amazing and he felt even better. I wrapped my arms around him, his cheek resting on the top of my head. I pulled back and risked a look into his eyes.
“Thank you,” he said. “I know you are going to say that you were just doing your job, but thank you. You have no idea how much of a blessing you’ve been to my family and me.”
“It’s no problem,” I said, not knowing exactly how to respond.
“If you ever need anything, please let me know,” he said.
I smiled. “Same goes for you.”
My entire body locked up as he leaned forward, giving me a gentle kiss on the forehead. It was soft and brief. Sweet and sad.
“I’ll see you around,” he said.
I nodded, my entire body somehow on fire from a simple kiss on my face. My brain wasn’t functioning enough for a coherent response, so I simply turned and walked away.