On Monday I start orientation to my new job working evenings in the Bone Marrow Transplant Clinic at Indiana University. I am looking forward to everything but getting up at 6 in the morning.
As part of my job search, I had subscribed to a number of nursing sites and discussion groups. Just after you offered me this job, I saw an announcement on the site NurseTogether.com for an essay contest. The prize was a $250 gift certificate at Tafford Uniforms.
I put together some of my thoughts about returning to nursing after my illness-imposed sabbatical. I am proud to say that I was informed last week that my essay “Resurrection” has been selected as the contest winner. The essay is featured on their homepage.
When I left nursing, first in 2001 and then again in 2004, I thought that I might die. As this spring season ebbs, I find myself returning to nursing, and to the place of my re-birth.
Just before Christmas, almost ten years ago, I was diagnosed with a rare type of cancer – T-cell prolymphocytic leukemia, described in the literature as “aggressive” and “invariably fatal.” I had been an oncology nurse for fifteen years, ironically caring for inpatients fighting some kind of leukemia or lymphoma. I guess I had forgotten to sign up for the dispensation.
I responded to a new biotherapy and achieved remission, only to relapse, as promised by the same literature, twenty-six months later. More biotherapy and then on to what may have been a curative treatment for an incurable disease – an allogeneic peripheral blood stem cell transplant. My immune system transplant, a literal re-birth, took place at the university hospital.
Seven years later I find myself returning to the same hospital, to the same transplant center – this time as a clinic nurse. An appropriate symmetry.
I had always said that I was a better human being as a nurse.
While I was fighting active disease and then enduring my prolonged recovery, I morphed into a different kind of person. My journey turned increasingly inward, familiar, and safe. My contacts with the world faded and become less immediate. For me there has been nothing quite like nursing for prodding my natural tendency toward introversion into an outward direction.
During my recent interview with the manager of the bone marrow clinic, I found that our conversation was punctuated by stories from my professional past, stories of patients and their families, stories of hope and fear, of tears and laughter.
I worked plenty of overtime over the years and was heavily involved professionally so my life was always dominated somewhat by cancer. That, of course, was nothing compared to the immersion into the world of cancer that has been my experience for the past ten years.
Throughout the trajectory of my illness and treatment, I have spoken about my experiences, both in person and in print. I have made my illness narrative inordinately public. If you google the name of my disease, you will find me in the first three entries – usually below the Wikipedia reference but just above that seminal article that predicts “invariably fatal” results. Consequently many people have contacted me over the years, patients or their families, about my leukemia and transplant.
I maintain two websites that I share with cancer survivors. One site has had over 108,000 visits. So I keep in touch. I thought I had my hand on the pulse of cancer. But that contact, though rewarding, has been mostly virtual.
Many of my fellow survivors refer to cancer as the “Beast.” Returning to nursing, this time as a survivor, is like returning to the belly of the beast. In working at the transplant clinic, I feel as though I am venturing into its heart.
I have been on disability for a long time. I will be working only about half-time, four or so hours five evenings week. I think that I saw this job opportunity as a gradual reintroduction to my nursing career. But in the days after my interview I realized that there was no such thing as returning to nursing halfway. If I want to be truly effective, I feel that I must be able to present myself wholly and authentically.
My return to clinical nursing may be marked by contradiction. I will need to formulate a healing identity that draws upon the best lessons of both worlds, that of professional care provider and that of cancer survivor. I was reminded just this morning that I am bound in each of those spheres.
I was awakened by a telephone call from a nurse at the occupational health center at the university hospital.Yesterday I went for my pre-employment physical. Blood was drawn since I will be giving chemotherapy in my new role. The nurse called to alert me that my blood count values were “off,” not diagnostically low but certainly on the far side of the bell-shaped curve of normalcy. An immunocompromised nurse working in the land of the immunosuppressed.
I have long said that I was at my best as a human being on this earth in my work as a nurse. With the experience of having faced the ultimate uncertainty in life, my approach to treating people with cancer will surely be “evidence-based.”
I have faced the “Beast”. I have won my battles. And now I am back. I am a nurse once more.