Kismet Connections

As a student, I distinctly remember walking into the workroom one morning to see my clinical instructor hunched over her computer, bawling her eyes out. I come to find out one of her patients, whom she had been working with, on and off, for the past five years had passed away. I don’t remember what I said to her, or if I said anything at all.

She told me to get started on our next patient’s treatment session as she remained in the workroom. It wasn’t until lunch time when we went over the morning’s notes, ate and went for a quick walk, that she started telling these wonderful stories about her patient. They had formed a true friendship over the years. She told me the only way she stayed at work that morning was because she received an email from the patient’s husband relaying the message that the patient had passed away under the exact conditions that she dreamt about: with her husband in a wonderful villa in Italy, no longer focusing on her cancer.

In my hospital rotation as a student, I knew that a percentage of patients would pass away there. I saw the trends in the chart and I witnessed the decline in their function. I prepared myself, but I wasn’t a part of their active care once it was their final decline. I never had the opportunity to get close with the patients in the hospital; my treatment time with them was limited.

I was at my last clinical rotation for 6 months. Split between Outpatient Oncology and Pelvic Health. During that time one of my patients passed away, however I only got to work with him for 2-3 weeks before he died. Again, I never built that connection. Nothing even close to the relationship my clinical instructor and her patient had. So, although I sympathized with her, I could not emphasize.

Over the last three years of my own clinical practice, I have had the pleasure of working with numerous wonderful patients. A few of which I was able to develop a deep connection. My friend calls it kismet.

With oncology rehabilitation, a good number of the patients are done with their cancer interventions and are working on improving their function to return to their life before cancer. Yet another percentage of patients are in the throes of fighting cancer, or nearing the end of their battle. Similar to the hospital setting, towards the end, you can see the functional decline, you understand that their time is limited. I’ve had a few of my kismet connections have their last physical therapy session. A goodbye without saying goodbye, and it wasn’t a ‘see you later’ either.

I have developed that bond with the patient, their spouse, their family. I understand, and now emphasize, with my clinical instructor. I know that sometimes, the inevitable happens. I feel those feelings too. I feel the sadness and the loss. The heartache.

And even though the foreseeable will happen, having a clinical background doesn’t make it any easier. Sometimes I think if I don’t confirm their passing, then there’s a small chance that they are still on this earth. But that’s not fair to them. I don’t wish any more suffering than what they already had to endure.

Today, I discovered two of my (favorite) patients had passed away. I worked with both of them on and off for the past 3 years. Today, I came to term with the fact that the inevitable happened. I am sad for their families.  I am sad. I know by working with this population, things won’t get easier. Death will happen. But because of these bonds, it motivates me to continue giving my all to my next patient. Fighting for them. Pushing them. Helping them reach their goals.

It also solidifies the thought that everyone in this community feels: FUCK CANCER. Fuck colon cancer, and fuck multiple myeloma. Fuck acute lymphocytic leukemia, fuck glioblastomas, fuck breast cancer, fuck cervical cancer, and fuck neuroendocrine cancer. FUCK ALL CANCERS.

I write this for all of my angels. My kismet connections. My college bestie. My coworker. My family member. And all of my past, current and future patients. Thank you for spending your time with me. I appreciate your commitment and desire. Thank you for teaching me, and making me a better physical therapist – a better person. I will never forget our time together. I will always cherish you in my heart. And to my last clinical instructor, Val, thank you for allowing me to see the vulnerable side of you. Thank you for saying it’s okay to love your patients and to grieve for them. That gift is invaluable.