End Notes
Sandra
Cancer-stricken but radiant, a woman demonstrates her courage and character.
By Andrew Day
Several months ago, I was on an otolaryngology rotation performing evening rounds with the team. We walked into the room of a patient—I’ll call her Sandra—on whom a team of surgeons had just operated for 13 hours. Sandra had stage IVa maxillary sinus cancer, which had required removal of several of the bones on the left side of her face, her parotid gland, and the lymph nodes in her neck. She was lying down, the head of her bed at 30 degrees. Her facial swelling partially obscured her eyes. When she saw us, she tried unsuccessfully to sit up and struggled to talk because of the new tube that went through her neck and into her windpipe. Still, from her reclined position, she extended both hands toward our chief resident. Grasping his hand between hers, she shook it sincerely, genuine appreciation in her eyes. Sandra proceeded to do the same for each member of the team, even reaching for the hands of the medical students who stood at the foot of her bed.
Sandra had been diagnosed almost a year earlier with inoperable cancer. She had gone on to receive grueling courses of chemotherapy and radiation. A subsequent MRI revealed the possible resolution of tumor in the bones containing her brain. Her head-and-neck surgeon had explained to Sandra that her prognosis was very poor regardless of what she did next. If she opted to do nothing, she had no chance of a cure. If she opted for surgery, achieving a cure was still unlikely, but the chance of success was greater than zero. He had also warned her that surgery might require the removal of her left eye. Sandra tearfully responded that she “wanted to try anything” to extend her life because she had “too much to live for.”
Our team grew to know Sandra well and enjoyed visiting her during morning rounds. Since her ability to communicate verbally was impaired by the windpipe tube, she spoke predominantly with her face. She beamed when we entered the room. Her countenance changed to pleasant and thoughtful when we addressed her hospital course and prognosis. As we left, she would again glow. Her “goodbye” was a characteristic wave. Her arm outstretched, she’d rapidly flutter her four fingers in synchrony, bespeaking her enthusiasm for our company.
Since leaving that otolaryngology rotation, I have encountered Sandra in the hospital on several occasions. I have seen her somber and even detached; but more often than not, she is radiant. Curious, I recently asked Sandra what motivated her. She wrote on her notepad: “my husband, my family, faith in God, and trust in the doctors and nurses.”
Sandra has demonstrated unmatched character during her clinic visits and months in the hospital. I know she is not immune to the travails of surgical complications, and I know she does not live in perpetual bliss. Still, her fortitude and vibrance have been deeply inspiring. Only a woman with unswerving purpose proceeds with a surgery to take apart her face and neck and possibly remove her left eye for the slim chance that she will be cured. Only a woman with time-tested joy persists in engaging others despite her pain, poor prognosis, disfigurement, extended hospitalization, and lost ability to eat, talk, and breathe normally. Seeing Sandra fight for her life has shown me, and many others, how to live. MM
Andrew Day is a fourth-year student at the University of Minnesota Medical School. This article is based on the speech he gave at the White Coat Ceremony in the Twin Cities.