1. Toth, Jennifer

Article Content

THE GIRL ON THE STRETCHER was 10 years old. Adopted from China, she was about to undergo extensive surgery to repair a congenital heart defect. For a moment, I saw myself: two and a half years old, bald, and about to have most of my liver removed along with the cancer in it. The other girl's parents' pleas to "take care of our baby" were muffled by sobs; sobs that I could only imagine echoed those of my own parents as they stood beside my stretcher outside a similar OR 18 years earlier.


I'm a nursing student. I'm also an 18-year cancer survivor. As a 2-year-old, I was diagnosed with hepatoblastoma, a rare primary hepatic malignant tumor.1 Within 6 months, I had six courses of chemotherapy to decrease the tumor size and two major surgeries to completely resect it. The nurses and my wonderful NP helped my family in so many indescribable ways that my decision to start nursing school 3 years ago was an easy one.


In a strange and surreal way, my life seems to have come full circle. My pediatrics clinical rotation several semesters ago was at the very hospital that saved my life. Suddenly I found myself there wearing scrubs and a hospital ID badge rather than a patient ID band.


Wrestling with full-disclosure

My clinical experiences since starting nursing school have made me confront my cancer history in new ways. As I watched parents send their kids into the OR or question nurses about when their child's medication was due, I realized that the hell that my parents went through during my treatment was even more excruciating than I'd imagined.


During this clinical rotation, I had to think more about the effects of my past treatments. For example, the hearing aids that I wear because of high-frequency hearing loss from chemotherapy never bothered me until I had to figure out what to do with them every time I went to use my stethoscope. I began to wrestle with the idea of self-disclosure: When is it appropriate to share my story without inappropriately turning the focus from the patient to myself?


I originally wanted to become a nurse so I could use my own experiences to help others going through similar situations. But when is it appropriate to do so in addition to simply empathizing with families in a way that communicates understanding? I still wrestle with these questions today.


Between two worlds

These questions are based on the reality that cancer has created in my own life, but I figure that they're not entirely unique, either. As nursing students, sometimes hardly 2 decades old, we're faced with realities that many of our peers never experience. For many students, the hospital at the corner of campus is where people go when they get a little too drunk on the weekend or are too sick to walk to student health. For nursing students, it's our classroom...a place where we watch a birth or death for the first time, experience the brokenness of the city, and witness every type of human emotion.


During clinical one day I watched an unsuccessful code, and I left the hospital wanting nothing more than to curl up in bed for a few hours and process the fact that, for the first time, I'd seen a person die. A glance at my calendar, though, reminded me that I had an exam later in the day for which I still needed to study. I felt caught between the world inside of the hospital and the one outside of it, where other students on campus sat chatting in lecture halls and dining halls while I walked back to my dorm wrestling with questions about the end of life.


When I graduate I hope to work on a pediatric oncology floor, and I'm sure these questions will persist. More will probably arise, too. How will I respond the first time I have a patient with the same diagnosis that I had? Will survivor's guilt creep up every time I lose a patient to the disease that I survived? Hopefully these questions will find satisfying answers over time. Until then, I'll just embrace the "caught in between" feeling that has become so familiar: Somewhere between a college student and a healthcare professional. And somewhere between a patient and a nurse.




1. Suriawinata A. Pathology of malignant liver tumors. UpToDate. 2014. [Context Link]