To My Friend Beverly, With Love

In my line of work, I am either looking at pictures of patients, or having one-time encounters with patients for short periods of time. It's rare to see the same patient more than a couple of times in a few years even. But I do have my own little collection of "private patients"--the people who have long-term indwelling tubes that need changing every few months or people who need things drained occasionally. Of those "private patients", my favorite was Beverly.

Beverly had initially been diagnosed with colon cancer eight years ago, beat the cancer, but was diagnosed with recurrence two months prior to my meeting her. The recurrence was fierce--it caused a blood clot in her right leg, making her leg swell to elephantine proportions in this 5'2" lady; it grew around her right sciatic nerve, causing her such pain that making the car trip from her home to the hospital was agony; and it lined her abdomen, keeping her body from absorbing fluids and leading to such horrible swelling that it even infiltrated her labia.

Her oncologist had given Beverly and her family the news that there was nothing more she could do to help. It was time for hospice, and drainage of the fluid from her abdomen (paracentesis) would provide some comfort. The oncologist called Jayne, my secretary, and asked if she could send Beverly over, because she was very uncomfortable. I think it was one of those days where we were sort of busy, and we just rolled our eyes and said, "Yes, send her over. We'll work her in."

I drained about six liters of fluid from her abdomen that day, and as that takes some time, we had the opportunity to chat and get to know each other. She had an obvious glow and peace about her that made her so pleasant to talk with.

After the drainage, she asked if she could come again next week, if she needed it. I said sure, but I planned on getting her to let me put a catheter into her abdomen that she could use to drain herself at home, so she wouldn't have to come all the way to the hospital every week. We had that discussion the next week, amongst the other discussions about family and activities. I gave her the informational DVD from the catheter manufacturer, even. But the next week, she said that it kind of intimidated her, and she really preferred coming in each week to see us.

So on it went. Every week, she came in and we drained fluid, talked about life and laughed. Kim was usually in on it, too, but sometimes one of the other techs was around. One time, our lead tech, Brian, was helping me. He said, "I feel like a third wheel! I can't get a word in edgewise!"

Most of the time, I saw Bev on a Friday at 1:30. She would get her drainage, then meet up with whatever grouping of her sisters had come to town to visit. Bev was the third of 11 kids who grew up in Arizona. The girls would get together and go to the beach, or Disneyland, or, when Bev got weaker, just would sit around and talk. I really don't think there was a weekend where there wasn't someone--sisters, brothers or a best friend from childhood--visiting.

I got to know a lot about Bev's kids and husband. She met her husband, Robert, when they were 14. They started off as friends, then married at 19. The waited a few years to have kids, going to college and starting their careers. The oldest, Shannon, was married and had taken time off from work to help care for her mom. Kyle and David were in college and working. Kyle lived away from home, but would come to his parents' every night to put his mom to bed when she stopped being able to do it herself. David's job was to massage Bev's legs to help with swelling and cracking. The youngest, Brent, was engaged to his high school sweetheart, Patty. He and Patty also lived at home and had their jobs taking care of Bev.

Kim and I told Shannon once how amazing and wonderful it was that she and her brothers so unselfishly were giving their time to care for their mom. She said, "She did everything for us our whole lives. Of course we're going to try to take care of her now."

As the months passed, Bev got weaker and weaker, but she was determined to make it to Brent and Patty's wedding on January 2. She had hoped to be able to walk down the aisle with Kyle and David supporting her, and she had a dress made that would cover up her swollen leg and abdomen. But it became clear that she would have to go down the aisle in a wheelchair. Her dress, though, was a gorgeous emerald green with an empire waist. Her short, dark, post-chemo hair was covered with a beautiful blond wig, and her makeup was perfect. I know this because Kim and I insisted that they bring pictures as soon as they could, but Kim and I really wanted to sneak into the wedding to see how everything turned out. The most amazing picture from the day was Bev and Brent dancing together, her face turned up to him smiling broadly, and his sweet expression as he looked down at his mother. She was glowing from within with love and pride, and it was breathtaking to see.

So the thing about Beverly, what made her so very special, was what a serene, loving, kind and happy person she was. She was telling us about some of the wedding preparations and different personalities of people that were involved, and she said, "You know, So-and-So just needs to be acknowledged and included. So we'll do this-or-that to help them and let them know that they're needed." It wasn't, "Oh, those people are being so lame!" or, "Well, we'll just take care of that and we don't need them." I'm sure those people felt good about themselves and the experience, instead of slighted or somehow in the way.

There are times when I really need to see someone modeling Christlike behavior to really help me understand what it looks like in real life, and that's what Beverly did.

We had talked about our respective faiths and what she thought the afterlife was going to be. She was raised Catholic and still went to mass, but she didn't feel like she really had a, I guess you would say, testimony of God. She knew I was LDS, and I really wished that our situation was such that we could talk more about the plan of happiness, but there still was that doctor/patient dynamic which made that a little bit iffy. Having grown up in Arizona, she had lots of LDS friends, and even went to Seminary in high school. I hope my friend Louise is teaching Bev the gospel now.

Bev really started to fade after the first of the year. She could barely get up on the procedure table, until, finally, I would just perform the procedure with her in her wheelchair. She would be lying there, drifting off because of her pain medication, and I would look away and think of other things. Then I'd look over and she'd have her big, green eyes open and the most beautiful, peaceful smile on her face, looking at me. That's what I'll always see when I picture her--her beautiful, peaceful smile in the midst of her pain.

At one point, I asked her if she would let me come to her memorial service. It seemed like a long way off, and she and I had been talking about the gravesite she'd picked. She said that she'd like that. So, last Monday, Shannon, Robert and David dropped by to tell us that Beverly had passed away. (Well, we already knew that, because Bev's hospice nurse had cancelled Bev's appointments about a month prior to that, saying that she was too weak to come in and was "actively dying". So we checked the computer every day to see if she was still alive.)

Shannon invited us to the memorial service, saying that Beverly really had wanted us to be there, and the family wanted us there because we had developed such a bond with them over the weeks and they so appreciated everything we had done.

Kim and I were able to take Friday afternoon off and attend the memorial and graveside services, and I went to the family reception afterward. Her husband, children, son- and daughter-in-law, two sisters, a brother and a niece spoke. Each one described a woman who was loving, selfless, kind, intelligent, thoughtful, beautiful, fun-loving, active and genuine. This was the woman I knew, just from my hour a week.

The last time I saw Bev, just before Valentine's Day, she was so weak she could barely talk. It wasn't much of a surprise that her nurse cancelled Bev's appointment for the next week, but it was a surprise that she didn't pass away until March 15. I asked Bev's sister-in-law why she thought Bev waited so long to go. She said, "Well, she wanted to make sure that she got past Shannon and Robert's birthdays. Robert said, 'She chose an insignificant day', which was just like her. She didn't want anyone to have sad memories on their birthday."

She left a legacy of love and service. I miss her, and I'm looking forward to being able to see her again someday.