Returning to work…

Back in March of 2004, I walked out of the cancer center where I worked.  I had just found out a week before that my leukemia had returned.  I did not know that this would be my last day as an ’employed worker’.  I went on medical leave to endure a second round of treatment.  That treatment was successful but we knew that the disease would return, probably sooner than my first 26 month remission.  Again we faced the decision of a bone marrow transplant.  I was two years older now.  Second remissions are harder to achieve as the leukemia cells that survive and sanctuary in the body are the most resistant ones.

I was transplanted in August 2004 with stem cells from my brother, Mark.  The rest is a story of survival from then til now, punctuated by a long series of infections that robbed me of my sense of smell and of vision in my left eye.  Three years on prednisone for GVHD (graft-versus-host disease) left my body weak and vulnerable.  But the important point was that I survived.

I puttered around, developed and discarded various hobbies.  Occasionally I gave presentations for pharmaceutical companies.  I spent time in the hospital two or three times a year and was sick with fevers a half dozen more times each year, spring, summer, winter or fall.

It wasn’t until this spring, after I saw a newspaper ad for part-time sales at a gourmet wine and spirits store, that I seriously considered returning, at least symbolically, to the working world.  The manager agreed to my stipulation that I probably could only work 10-12 hours per week.  I reckoned that it would be good for me to get out in the world on a more regular basis.  Blogging and its ethereal patterns of communication can keep one safely in seclusion.  A few extra bucks would be nice to.

Returning to work has mostly worked out well.  Pouring wine and ringing up whiskey on the cash register are not taxing.  The store has a relaxed atmosphere so it is generally a low stress environment.  My shifts are generally late afternoon to early evening, usually only about three hours long.  My co-workers are friendly and interesting.

My thought was that I could recast myself fairly readily into the role of a gainfully-employed person.  But I discovered that this reinvention of self would necessarily pass through the filter of my altered self, my survivorhood and all the baggage it entailed.  The first week I broke two bottles of wine due to my lapse in peripheral vision and general clumsiness.  The same vision issues show up each time I need to search for a particular bottle among the racks and stacks.  The skill of scanning  items, whether on a grocery store shelf or in a junk drawer, is handicapped by my acquired monocular vision – no depth of field so that things appear flat and do not stand out from the background.

On my first day of work I was instructed to hang around the tasting bar and spend some tasting tasting the wine, beer, and spirits available there.  I needed to begin to develop a descriptive vocabulary and discriminatory palette.  I needed to be able to give personal recommendations, to able to freely throw out suggestive terms.  The store’s recent newsletter contains phrases like”the nose is full of leather and sherry notes…Lots of chocolate and caramel with a lovely long finish” and “a subtle Reisling with aromas of lime, green apple, apricot, and undertones of fine blossoms.  A distinct play between sweetness and acidity.”  These are the words that afficiandos use to communicate.  They express both the real and perhaps imagined experience.  But viral infections over the past several years diminished my sense of smell and, thus, taste.  So I can tell sweet from sour, harsh from soft, bitter from smooth, but only in the broadest sense.  The subtleties of taste and smell elude me.

I was surprised then that, at least for this particular job, my recently acquired disabilities, afflictions that I normally try to minimize, so obviously hindered my development as a gourmand.  I had only succeeded partially in achieving that longed-for sense of normalcy.  I did not feel so much a normal person with a new job as a slightly disabled one surprised at the struggle to adjust.  This is not to diminish the great pride I felt when I took my check to the bank, physically depositing most while keeping a little cash for myself.

Then, as I have written over the past few weeks,  I was overcome by one of my periodic “viral episodes”.  I had to call in sick two days before I had even been on the job for two months.  I returned for one partial shift but felt weak, short of breath, and dizzy.  On my next scheduled day I had to call in once more.  With my continued hypotension and anemia, when I did finally return to work, it was again in a diminished, half-strength capacity.  One of my fears about returning to work was just this, that I would be chronically sick, calling in, unable to accumulate sick time or other benefits.  Of course with a ten-hour a week schedule I did not expect benefits.

The people at work have been understanding.  My six month evaluation is months off.  My identity as a “sick” person persists, defying any impulse to feel normal again, to feel unscathed.  But such impulses are probably ill-considered.  The message plays over and over in my head that I should feel totally gratified that I am even still alive.  I do, well, perhaps not totally.  Life goes on and that is the singularly important point.  My next shift starts in two hours.  I can only hope that I don’t break anything.

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About Dennis Pyritz

Dennis W. Pyritz, RN, BA, BSN, has been a cancer nurse since 1987 and a cancer and bone marrow transplant survivor since 2004. In December 2001 he was diagnosed with t-cell prolymphocytic leukemia (T-PLL), a rare aggressive form of chronic lymphocytic leukemia (CLL). Dennis was treated with the then new monoclonal antibody, alemtuzumab (Campath) as this disease has a median survival of 7.5 months. He achieved a 26 month remission but relapsed in February 2004. He was retreated with Campath and went into a second remission. In August 2004 he underwent an allogeneic peripheral blood stem cell transplant with his brother, Mark, as donor. Dennis has remained in remission since - a near miracle. Throughout his career as cancer nurse and patient, Dennis has had the opportunity to speal to both lay and professional groups. Dennis has spoken on cancer topics and survival issues across the country as well as in the United Kingdom, Norway, Austria, Portugal, Honduras, Panama, Guatemala, Trinidad, United Arab Emirates, Jordan, Cyrpus, Israel, and India.

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