By Laura B. Vater, MD, MPH
Julie carried the news of two diagnoses, coming just weeks after burying her son: Multiple myeloma and amyloidosis were the unfamiliar words that finally explained her decline. She first welcomed the diagnosis, then despaired.
In her black shoulder bag, she carried the bills of two other hospital visits, as well as Zofran, Compazine, and Phenergan. The medications were not enough to quell her nausea. It was only the tube connecting nose to stomach that provided solace—an outlet backward when nothing in her small bowel advanced forward.
On her table sat an assortment of teas, juices, and ice. After days of futile attempts to drink, a milky-white fluid dripped calories into her veins.
She carried sympathy cards from her family and friends, and propped them up along the windowsill. Some didn’t know what to say, so said nothing.
She carried the decision for chemotherapy, and signed the consent form I held. This treatment only worsened her symptoms, and the pain began to keep her awake at night.
When I asked her how she was carrying all of this, she could answer with only a single word: “Fine.”
Fine. Fine. Ever fine. As her throat tightened and her voice cracked. As the tears rolled down her face and into her flowered yellow mask.
And I could answer with only a single word: “Good.”
Good. Good. Ever good. As tears welled in my eyes and I pushed them back.
Julie carried the questions her family asked her: What now? What next? What if?
I carried the responsibility of answering those questions. As a new fellow, I also carried my own uncertainties. I carried them along with my disappointment when each day brought no improvement. I concealed my sadness, but carried it still. I carried this all with my navy stethoscope, my spiral-bound survival guide, my phone that frequently chimed to page me.
With each passing day, Julie carried the realization that her disease was unlikely to improve. She carried the decision to forgo further chemotherapy. She chose to go home with hospice.
I witnessed her release the things she carried. And saw, in her face, relief.
Laura Vater, MD, MPH, is a Hematology Oncology Fellow and a Gold Humanism Honor Society member. She was part of the first cohort of the Gold Writing Workshop with author Judith Hannan. This essay emerged from an exercise in the workshop, inspired by Tim O’Brien’s “The Things They Carried.”
Laura has published two essays: “The Before and After,” in the Journal of General Internal Medicine, April 2020, and “In the Valley,” in the Journal of General Internal Medicine, accepted in December 2020, to be published this spring. She is currently in the editing phase of her first novel.
Laura shares her writing on her website. She also shares pieces of her work on Instagram and Twitter: @doclauravater.