Rochester, Minnesota, United States
I scan the chemotherapy data into the computer system, noting the date of birth listed at the top right of the screen. Happy birthday, I say, hanging the bag of liquid on the IV pole. Thanks, he replies, and we share a contemptuous laugh. It feels like a sick joke, but what else do you say to someone on their birthday? What else do you say to someone you are about to poison at two in the morning ?
I leave the room, take two pieces of hole-punched computer paper from the printer, and collect a handful of neon highlighters. My mental task list groans, begging me to consider if this is the best use of my time. I ignore it, scribbling “Happy Birthday” in glowing block letters, hurriedly. I frown, wishing I had time to make a better sign. I tape the papers to the bottom of the TV screen in his room. He and his friend thank me. I can see they are touched, yet I leave the room feeling empty inside.
The poison drips through his thirty-something -year -old veins into the early hours of the morning. How strange it must feel to him, how hurricane-like. He received the surprise diagnosis only weeks ago.
Appropriate surprises for birthdays include: getting a raise, taking a spontaneous vacation, finding twenty dollars in your pocket, seeing an old friend at the store, making five dollars on a gas station scratch-off, and puppies. Anything but surely not cancer.
I cannot fathom what is going through his mind. Yet he handles it with grace. He treats those around him with kindness. His family orders pizza at four in the morning and invite me to join them. His mother has taken his place in the bed at his request. He is stretched out on the recliner, hands behind his head, ankles crossed like a king. A paper plate sits on his chest, barely visible beneath a large piece of supreme pizza.
What do you say to someone who has cancer on his birthday?
He and his family joke and make conversation about normal things. They talk about the things people normally discuss on one’s birthday. They sit silently and stare at the gray walls. They watch TV. And I learn what to say by listening.
I am continually astonished by the bravery of my patients. We often think of brave people as powerful — those with a microphone or those who move across the world to tackle big issues, who have recognizable names. Yet I have met some of the bravest people in the middle of the night in cramped hospital rooms. They talk about the weather and their interests and their favorite TV shows. Sometimes, I do not know what to say to them. At times the answer may be to simply wish them “Happy Birthday.” At other times the answer is to listen and say nothing at all.
LAURA ANNE WHITE, BSN, RN works on an inpatient adult oncology and hospice unit at the Mayo Clinic in Rochester, MN. She received her Bachelor of Science from the University of Texas. Her writing and artwork have been featured in the online blog Recovering the Self, Hektoen, and Intima.