BMT Challenges Every Human Spirit
Nurses in our unit often are asked a probing question: “How can you work in bone marrow transplantation? It seems so emotionally difficult.”
Without a doubt, BMT patients go through one of the most traumatic treatments in cancer medicine. They receive essentially lethal doses of radiation and high-dose chemotherapy, then are rescued with supportive therapy. Yes, it is difficult to see them suffer. But guiding these patients and their families through this passageway is a very rewarding experience. The nurse-patient relationship often reaches extraordinary levels of intimacy.
This really hit home a few months ago. My patient was a nurse from another hospital. At age 48, after a routine blood test for an insurance screening, she received frightening news. She had acute lymphocytic leukemia. She needed a bone marrow transplant as soon as possible. Her family members were not HLA-compatible, so after an agonizing wait, a suitable donor in Europe was identified. Everyone was relieved to get the process started.
But following the transplant, her condition deteriorated. Profound liver and renal failure set in, and she became comatose. Her devoted husband, sons and daughter watched helplessly as this woman, who had been a healer of so many patients, slip away. On Sunday, I watched as they said their good-byes. I didn’t expect to see her when I returned to work on Tuesday.
Amazingly, she rallied. One day, she surprised her husband by meeting him at the door in a wheelchair. At the end of another day, I kicked off my shoes and joined her for a cup of coffee. Sadly, she died several weeks later from pneumonia, but her husband later sent me a letter, saying how much it meant to walk into his wife’s room that day and see her sipping coffee and talking about the cherry blossoms in Washington, D.C. I hadn’t realized how much a moment of sheer normalcy could mean to a patient and their family.
Faced with a terrifying disease, would you undergo BMT? Some people say they wouldn’t. But when in good health, it’s not easy to predict our reaction. These illnesses usually catch people by surprise. Many go from something as non-threatening as a
pre-employment blood test, chronic back pain or lingering sore throat to a frightening diagnosis and treatment. But BMT is no longer a therapy of last resort. It is often the front-line approach for diseases such as chronic myelogenous leukemia. And with today’s medical advances, patients are returning home in 30 to 40 days, about one-third the hospital stay of 17 years ago, when I started in this field.
People making such a decision are bolstered by a profound sense of survival and the encouragement of families, friends and colleagues. As nurses, who daily encourage our patients to endure short-term discomfort to achieve long-term results, it is in our character to do the same — to always embody and convey hope.
—Myra Muir, BSN, Staff Nurse
BMT Intensive Care Unit, Tower 6A