Terminally Ill, a Nurse Offers Herself as a Subject of Study
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Posted about 1 year ago
In 2006, after she had felt sick for several years, a doctor finally ordered a CT scan, and the cancer was diagnosed. Ms. Keochareon was 53 and working at a hospital in Charleston, S.C. She was told that she would probably die within a year or two.
Ms. Santiago and Ms. Elliot were outraged on her behalf. But they were surprised, they said, to learn that instead of anger or shock, the first emotion that Ms. Keochareon felt after her diagnosis was relief because she finally knew what was wrong with her.
The best advice she could give future nurses, Ms. Keochareon said in her reedy voice, was “to just dig a little deeper — you know?”
Ms. Keochareon — who had several unhappy marriages before finding her current husband, Joe — also offered some personal advice. “Don’t yell at each other unless the house is on fire,” she told the students.
Perhaps more than anything, the students were learning about the challenge of managing late-stage cancer pain in a patient who had outlived her prognosis. Ms. Keochareon’s cancer had spread, and there were tumors in her bones and around her throat. By early December, the pain had grown unbearable; Ms. Keochareon was hospitalized for nearly a week while doctors assessed how to control it.
‘Let the Patient Talk’
At her request, the students kept visiting. The sessions provided a brief respite for Ms. Keochareon’s caretakers, including Roy Christensen, a cousin who moved back from Texas last year to help, and Peggy Casey, her favorite aunt. Seeing their exhaustion, the students learned another lesson: “The patient isn’t Martha per se,” Ms. Keane said, “it’s the entire family.”
At Ms. Keane’s urging, the students eventually stopped asking questions and practiced what she called “therapeutic communication” instead.
“The way we’ve learned in school, and haven’t applied enough, is just saying, ‘I’m glad to be with you; you must be frustrated; you look uncomfortable,'” Ms. Keane said. “And let the patient just talk and talk and talk, and see where they’re at.”
On a bright day shortly before Christmas, Ms. Keochareon had less to say than usual as Ms. Santiago perched on her bed.
“You look good,” Ms. Santiago said softly after they had chatted for a bit. Ms. Keochareon was clearly in pain; she mustered a brief smile and closed her eyes.
“I’m ready to go,” Ms. Keochareon told her, opening her eyes again.
Ms. Santiago paused. “Aw,” she said, patting Ms. Keochareon’s hand. “Well...”
“Don’t feel bad,” Ms. Keochareon added.
“I know,” Ms. Santiago said, shaking her look of concern into a smile. “I know.”
She wept after leaving the room. Her father has prostate cancer that has spread, she said; Ms. Keochareon’s declaration had left her thinking about him.
“I kind of wanted to break down,” she said. “I know I’m going to get there with my dad eventually.”