This playful photo is one of the fondest memories I have. It sits on my fridge and reminds me of happy days on the beach, being silly and dancing under the stars, and driving with the ocean breeze blowing in my face. She is why I became a nurse.
Sophie, aka Sofia, was as sophisticated, strong, and chic as they come. When I say sophisticated, I am not kidding. For her, even housecleaning required a button-down oxford polo with a popped collar, pressed jeans, and loafers. But being chic also drew her to the allure of smoking. Sofia is my grandmother.
Sofia was first diagnosed with cancer of the tongue when I was in middle school. She had a tumor that required radiation. With time, effects of the radiation began to appear. It became hard for her to swallow, she relied on a diet of eggs, mashed potatoes, and ice cream (and of course martinis). Her jaw bone became brittle from the radiation which changed her chin and eventually needed reconstruction. Afterwards It always curved towards the right and had a slight concave appearance. Her teeth were damaged from the radiation which meant she needed special dental implants. Nevertheless, she was always strikingly beautiful.
“I arrived just in time to witness the most extraordinary thing. The internal medicine doctor came in, knelt on one knee next to my grandmother, and held her hand. In a soft voice, he looked her in the eye and he explained that her cancer had returned. It is a moment that is seared in my memory.”
The Day Everything Changed
This photo was taken long after those treatments, I was in college planning to study medicine. Then everything changed. I remember the call from my parents. I was out to dinner with friends while they were in the Emergency Room. They told me I needed to come right away.
The months that followed were a whirlwind. My grandmother decided to forgo extensive surgery, and focus on palliative care. She decided on quality of life, not quantity of life. The tumor continued to grow. To help keep her to be able to breath, the doctors placed a tracheostomy, a tube in her neck to breath through. In order to feed her they placed a feeding tube. She required so much care and attention.
Time to Go Home
When we were told it was time to think about going home, we were scared that we wouldn’t be able to care for her properly. So we went to tour skilled nursing facilities. All it took was touring one center for us to decide this was not going to be an option for her. There was no way we could ever imagine letting her stay in a skilled nursing facility, we wanted more for her. So as a family, we arranged 24-hour care amongst our family members.
The decision to take her home meant that we needed to learn to care for her and all of her medical needs. It was scary and overwhelming, but the nursing staff at the hospital patiently taught my family how to care for her. They taught us how to suction and clean her tracheostomy, and what to do in an emergency. They diligently taught us how do tube feedings, managing wounds, and everything else we needed to know. The nurses made the scary, not so scary. With practice, our confidence grew, and we brought her home. This is when I decided to become a nurse.
For Months One of Us Would always Be With Her
I stayed with her mostly at night time, which meant I was beyond sleep deprived. It was like I slept with one eye and ear open. I was always worried about her breathing or scared she may develop a mucous plug in her tracheostomy and I wouldn’t know it. There were days when she would passed out while walking because she was so weak or dehydrated. Nights that I would crawl ten feet at a time with her on the floor to get to the bathroom because she refused help and had to get there on her own. There were even nights I had to call 911 because there was somethings so wrong with her that even I couldn’t manage them alone. 911 would make me ride the 1.5 miles in the ambulance to the hospital because even they didn’t know what to do.
The last time I called the paramedics, was her last hospitalization. She woke me up coughing. When I turned on the light there was blood coming out of her tracheostomy with every cough. This was it, I was so scared. Her medical team explained that we should focus on quality of life. We found refuge with her at the Sherman Home, an inpatient hospice facility next door to the hospital. Although my grandmother wanted to be home, each family member needed a break from being 24/7 caregivers. We wanted to enjoy the last bit of time left as family.
Laurie-Why I Became a Nurse
In true Sophie style, she was discharged on a rainy night. She was wheeled out in a trendy white puffy jacket that belonged to my sister. From the moment she arrived at the hospice home, she bonded with a nurse named Laurie. Laurie could read Sophie like a book. She would jokingly call her “cheeky”. She helped Sophie work through the last few things on her mind and settled her spirit. Laurie also helped the rest of the family process what was happening. She helped prepare us as things began to permanently change. Somehow, in just days, Sophie and Laurie had developed the most extraordinary relationship.
Until then, I had never known the power of a nurse. I never understood exactly what they did, and to be honest, I didn’t even recognize the deep importance of their role. This is exactly when I realized that being a nurse was my calling.
Around 4am one cool February morning, Laurie called to tell us this was the day. Laurie sat with us as long as she could after shift because she had promised my grandmother that she would be there when she passed. Laurie had dogs and children and needed to sleep before coming back later than night, she needed to leave. Our family stayed with my grandmother all day, watching her take as little at two breaths every minute, all day long, until the sun was setting.
The days end was near night had come and Laurie ran straight into Sophia’s room. She was surprised we were still there she told Sophia to hang on a minute while she put her things down. She quickly returned, and with all of us by her side, Laurie whispered to her, “It’s okay, I am here now, you can go”. And with that, my grandmother took her last breath. This is why I became a nurse.
In the greatest irony of all, I have had the pleasure of being able to work alongside some of the same nurses who taught me how to care for my grandmother so many years ago. I can’t even begin to explain the joy that has come from this. I have also had the honor of being able to care for patients and families in similar situations. Being able to relate to them makes all the difference in our interactions. And finally, that internal medicine physician who knelt on one knee has since become one of my dearest mentors and supporters.
I became a nurse to return the gifts of listening, compassion, education, clinical astuteness, and support that my family and I were so graciously given many years back.
Love and Best of Health
Jasmine Bhatti PhD(c), MS, RN, Co-founder, CEO