A patient came into today with his wife and son.  This patient had lymphoma and we have treated him for the past two years.  Today was his last treatment with us and the anniversary of his diagnosis.  His wife couldn't stop smiling. 

I'm thankful for that. 

It's been a difficult year.  We have worked for the majority of the year short staffed.  My boss believes that all we do is start IVs.  He knows we do a few other things but my main job is to start IVs and help radiologists insert central lines. 

Except that's not my main job.  My main job is to care for my patients.  That means I listen to my patients.  I look at them as they stand up and as they walk down the hallway.  I check to see if they're tired, if they're in pain, if they're better or worse than when last I saw them.  Is there a family member with them, when they always used to come by themselves?  Are they leaning on a cane?  Being pushed in a wheelchair?  Are they having pain?  Is their breathing okay?  Do they have a fever?  Do they need to lay down? 

I need to understand at least a little about their type of cancer and there are as many different kinds of cancer as there are different types of cells in the human body.  I need to know that breast cancer spreads to the bones and lungs and liver and brain.  I need to know that small cell lung cancer spreads to the brain.  I need to know that Burkitt lymphoma is the fastest growing human tumor.  I need to know that ovarian cancer can cause kidney problems.  I need to know that colon cancer spreads to the liver and that rectal cancer spreads to the lungs. 

Our patients come back to us over and over again.  We see them get better and we see them get worse.  They trust us.  They rely on us to answer their questions and to hold space for them.  So when a patient starts crying because her girlfriend and lover of twenty-five years was found dead of a heart attack and it was supposed to be my patient that died first, I sit and listen.  When a terrified six year old needs an IV started, I tell her a story about my own little girl, Miss Katie, who doesn't like needles either.  And when a patient tells me they won't be coming back because the doctor has told them this is the end I hug them and I cry. 

Biopsy patient's end up with chest tubes inserted because their lungs have deflated.  Transfer patients from out of town can be too sick to send back.  Patient's can have so much pain they can't move.  There are fevers and chests filled with fluid and obstructed bowels and leptomeningeal disease.  There is pain and fear and fatigue. 

And we don't just care for our patients, we care for their families as well.  Because often times it's harder to watch someone you love suffer than to suffer yourself. 

So when I hear my manager say they don't want to cancel any lines just because we're short staffed, it hurts because I know I will have less to give to my patients.  What I want, what I need is for someone to care about me so that I can care for my patients.