1. Roush, Karen MSN, RN, FNP


Hope takes on a life of its own.


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It was a bad night for Tony. His pain was worse than usual and his breathing, even more ragged. I was starting six weeks of family leave the next day, and this was probably the last time I'd take care of him. Although Tony and his wife, Anne, stayed hopeful, the experimental chemotherapy he was getting for lung cancer wasn't working. "I've been a fighter all my life," he said as I started his infusion. "I ain't about to stop now." I wished he would stop, as I watched the toxic drugs wind their way up the tube to the needle poking from his chest, knowing he'd spend the night clutching an emesis basin while nausea convulsed his body, that he'd deteriorate despite it all.


I knew about hope, how hard it is to give up. And how hard it is to find again once you have. Two years earlier I'd watched my son die, still believing he would live until the last heartbeat had faded from the monitor. Because of life-threatening complications during his birth, I was advised against another pregnancy. My first son gave me a reason to live, but I didn't think I would ever feel hopeful again.


A year later I started the process of adopting a baby from Korea. After eight months we received pictures of a six-month-old baby girl and decided to name her Kimberly. We were told she'd arrive in three weeks. It was 1983 and international adoption was less common; within a few days even my patients were caught up in the anticipation of her arrival. I was asked so many times to show her picture that I kept one in my uniform pocket. "See," they'd say to their visitors, "didn't I tell you she's beautiful?"

Figure. Illustration... - Click to enlarge in new window by Lisa Dietrich

Within days, however, anticipation turned to uncertainty. The Immigration and Naturalization Service threatened to refuse to issue Kimberly's visa. The moment I was given Kimberly's picture, I'd become her mother. I couldn't bear the thought of losing another child; afraid to hope, I put away her crib and photo.


But my patients lived on hope-for another breakfast, a good night's sleep, a date a month from now penciled in on the calendar. They reassured me while I turned them and changed their dressings and piggybacked antibiotics into their ivs. They offered advice, gave me names of people to contact.


Weeks passed, then months, my daughter growing up away from me.


"I know people," Tony would say. "Let me call my people." He insisted he was "in good" with the local congressman and one night he made a call.


"Jerry, how you doing? Yeah, I'm still hanging around. Listen [horizontal ellipsis] I got someone here, you gotta help out. She's waiting for her baby, and that goddamn immigration, they're holding up the works. This baby's gotta get home."


I never needed the congressman's help. The next morning I got the long-awaited call; Kimberly was coming home.


So a week later Kimberly was on a plane somewhere over the Pacific, and Tony was having a bad night. I increased the rate of his morphine drip and spent a few moments talking to Anne. Outside, stars punctured the clear sky; it was hard to believe that the biggest blizzard of the century had been predicted to hit New York City just in time for Kimberly's arrival there the next day. Tony reached over and squeezed my hand. "Don't worry," he said, "in New York a blizzard is six inches of snow. It'll be nothing."


Before leaving that night, I stopped one last time in his room. He took my pen and wrote a number on the back of a get-well card. "I know this guy at the airport. Any problems, you call him," he said. "Tell him Tony, from the old days in Brooklyn, told you to call."


The blizzard arrived as predicted, closing all the airports in New York. We drove for hours through the storm, only to learn Kimberly's flight had been diverted to an airport close to home. When we arrived almost a day later at the home of the social worker who had met her at the airport, I finally held my daughter. In Korean the social worker told her, "This is your mother," and Kimberly screamed, struggling to get out of my arms, frightened and confused. I wanted to tell her it would be all right, that there is loss but also love. I wanted to tell her about hope.


A week later I brought Kimberly to the hospital. Tony smiled widely when we entered. Anne took Kimberly and sat on his bed. "We've all been waiting a long time for you, little one," he said.


He died that night.