by Claudia Meininger (Gold), 1988
I had never prayed for anyone before. I mean, I’m not religious at all. Yet, there I sat in my hospital scrubs, alone, on the floor of the nurses lounge beside a row of green lockers, praying to God to save Elizabeth’s life.
When I met Elizabeth the year before, she had already been labeled a “difficult patient.” This label came from the interns, of which I was one, because she would often refuse to take her medicine, and would threaten to leave the hospital A.M.A. ( against medical advice.) The threats to leave usually occurred around 2am, causing the intern on call to be up all night negotiating with her in the deserted hall of the adolescent ward. I was on that ward the second month of my internship, and she became my patient.
Elizabeth, an attractive 15-year-old Hispanic girl, had non-Hodgkins lymphoma and was on chemotherapy. When she was not in the hospital, she lived with her mother in a poor neighborhood in the Bronx. On those rare occasions when she came to visit Elizabeth in the hospital, her mother appeared tired and worn. She was so caught up in her own hysteria over Elizabeth’s illness that she was unable to give support. No wonder Elizabeth was tough.
She certainly was a challenge. During that month of my internship on the adolescent ward, I had to give her a shot of and anti-cancer drug every other day. The needle was large and the injection painful. At first there were scenes, Elizabeth yelling and fighting, and the use of force by several strong nurses and doctors for every shot. But over the course of the month, we got to know each other and to figure out together what we needed to do. Eventually we struck a balance, with me using just enough firmness to get the job done and yet still allow Elizabeth to maintain some sense of control.
When Elizabeth hurled streams of curses down the hall in her thick Spanish accent, she could be downright scary. But as she learned to trust me, another side came out. She began to express her fears. She spoke with tenderness about her baby niece. She revealed distress over losing her hair because of the therapy. We had long talks about her life at home, and we even had some good laughs.
I left that ward for other stations in my residency, and it was not until a year later that we met again. Things were much worse. Elizabeth’s cancer had converted to a leukemia.
I was the junior resident, now responsible for all of the patients on the ward where we had first met. One morning I got a call from the emergency room. “Elizabeth is here. Her temperature is 102, her pulse is 160, blood pressure 60/40 and she looks very pale.”
She was in septic shock, or bleeding, or both. She was very sick. She needed I.V. fluids and antibiotics, and she needed them fasr. I ran down there, and although I knew the right medicine, I was not prepared for the challenge that faced me when I arrived. Elizabeth had unhooked her I.V. and was on her way out the door. If she left she would surely die.
Relying on the strength of our alliance, I took her by the hand and said, “You’re not leaving. You’re coming with me, and we are hooking up your I.V.”
Out came the string of curses, but she followed. We got the treatment started, and I brought her upstairs to her room. I stood by her bed, pushing albumin through her I.V. to keep her blood pressure up. It was then that she started to cry.
“I’m scared, ” she said softly. “I don’t want to die.” Then, “Will you pray for me?”
There was much work to be done on the ward, but at that moment my clipboard ceased to exist. This young girl, so tough yet so fragile, was reaching out to me, and I wanted to be there for her. That’s how I found myself soon afterwards, on the floor of the nurses’ lounge.
After receiving blood and antibiotics, Elizabeth got better and went home. Six months later, on Christmas Day, I was on call in the Intensive Care Unit when I learned that Elizabeth had been admitted down the hall on the adolescent ward. I left my quiet unit and went to visit her.
The resident covering the ward met me in the hall. “There’s nothing we can do, he said. “She’s a D.N.R ( do not resuscitate).”
Christmas is always a strange time to be on call. The halls have an eerie quiet, and the people working feel a sense of dread that something terrible will happen.
I knocked on the door and walked into Elizabeth’s room. Wearing her thick black wig, she was a pale grey color against the white sheets. She was so thin. “I’m dying,” she whispered. There was silence for a long time. Then she asked, “Can you get me a present?”
I didn’t hesitate. I went down to the infant ward where there was a box of toys for hospitalized children and brought up a little stuffed dog. She clutched it close. We made small talk for a while, and then I had to go back to work in the I.C.U. Things got busy, and I worked all night and half the next day, hurrying to get things done, because it was beginning to snow heavily.
I went to say goodbye to Elizabeth. She was awake, calmed by a dose of valium. The little stuffed dog was still close by her face. I told her about the snowstorm, and then, as I was on my way out the door, she called to me. “Dr. Meininger, she said in a frail voice, “Drive carefully.”
Elizabeth died that night. Now, I wish I could thank her. She let me care for her, and what a wonderful gift that was.