On Wednesday or maybe it was Thursday, she got sick; she had a headache and was vomiting. The oncologists figured it must have been due to mets in her brain [metastases to the brain cause increased pressure within the skull, leading to symptoms such as headache, vomiting, irritability, etc.]. We started chemo [chemotherapy] on Thursday afternoon, but that didn’t help. In fact, she felt a hundred times worse; she spent all yesterday vomiting. It’s pathetic.
I hate going into her room. On the one hand, I know her prognosis isn’t bad, even with the mets; but on the other hand, I know what this girl’s going to have to go through over the next few months: She’s going to have a lot of chemo, her hair’s going to fall out, she’s going to be vomiting constantly, she’ll have to spend a lot of time in the hospital. Also, if we can’t eliminate the cancer with chemo, the next step is to do a hysterectomy. It’s really sad. And so sudden; I mean, one day, she was looking forward to having a baby, the next day she finds out that not only is she having a miscarriage, but also she’s got cancer that’s spread all over her body, and if it can’t be controlled with medication, she may have to have a hysterectomy and never be able to have any children. She’s very depressed; you can’t blame her. I haven’t told her about Sarah. I don’t know if it would be good for her to know I’ve got a baby. It might depress her more.
She’s the worst, but they’re all like that. I’ve got an eighteen-year-old who’s got a brain tumor. He was fine until about six months ago, when he started waking up having to vomit every morning, with really bad headaches. He came to the emergency room; they did a CT scan, and it showed this huge mass. He’s spent a lot of time in the hospital, getting the works, surgery, chemotherapy, radiation, but he’s just gotten sicker and sicker. At this point he knows he’s going to die and he doesn’t want anything done anymore. He screams at any doctor who comes near him. He only trusts one person and that’s one of the nurses.
The only good thing about working on this ward is that there’re a lot of doctor types around, so nobody gets too many patients. We’ve got three interns and two subinterns on our team and the whole ward holds only thirty-five patients, so the most anyone can get is seven if things are equally distributed. But seven of these patients are worth fourteen University Hospital patients!
There is one other good thing about this ward: Susannah’s working here this month, too. If she hadn’t been around last month, I’m positive I would have gone crazy. As it was, I don’t know how I survived it. So it’s good to have her here. But I can see that neither of us is going to be able to keep the same hours we had last month. The days of getting out at three o’clock in the afternoon are definitely over.
Things at home are quiet. Sarah has a little cold, but I don’t think it’s too bad. I’m not worried about it. I’ve been feeling kind of sick myself, so I think we’ve probably got the same virus. I spent most of today sleeping. I’m on tomorrow, so I won’t get to spend any time with her again. It’s really impossible being a mother like this.
Thursday, October 10, 1985, 9:00 P.M.
What a week! This has definitely been the worst week of my internship. Every bad thing you could think of has happened to me. And it’s not over yet. I’ve got all day tomorrow and I’m on Saturday.
First, Sarah got sick. She woke up last Saturday night at about 3:00 A.M., screaming her brains out. She had a fever of 103 and she just wouldn’t stop crying. I was sure she had meningitis; that’s what kept going through my head, “She’s got meningitis, she needs a spinal tap, and she’ll have to be hospitalized for two weeks and then she’s going to end up retarded and I’m going to have to go to work tomorrow and every day from now on and try not to think about it.” I somehow got her and myself dressed and we brought her over to the Jonas Bronck emergency room. She kept crying all the way over; she was inconsolable. Rhonda Bennett was the night float. She saw Sarah right away. I was sure she was going to examine her and turn to me and say she needed to draw blood and do an LP [lumbar puncture], but no, she found that all it was was a bad otitis [otitis media: infection of the middle ear, a common medical problem during the first few years of life]. She just gave us some Amoxicillin [an antibiotic used to treat otitis media] and Tylenol and said she’d be fine in a couple of days.
What a relief! We went back home but I didn’t sleep a wink for the rest of that night. Sarah stayed up screaming until about five in the morning, when I guess the Tylenol started to work. She finally fell asleep, but I had to get up and go to the hospital and be on call like usual, as if nothing had happened. I was tired and nauseous and I couldn’t concentrate on anything all day except Sarah. I called Larry about forty times. Sarah had a fever most of the day but it was gone by the night and Larry said she looked better.