I am waiting in the hallway of the women’s clinic for someone to call me in for my first round of chemotherapy. Sixteen days earlier I walked into the emergency department with vague stomach complaints and a supersized belly as if I was going to give birth at age 59. Several blood tests, a CT scan, ultrasound and medical checks later, I was called in by a young doctor. “I have the diagnosis,” he said briskly. Two minutes later, I walked in horror back to the crowded waiting room. You need to come, tumour in ovarium and metastasis in stomach and liver, I messaged my husband.
*
Since that day, I’ve been in and out of the hospital, undergoing more tests, seeing gynaecologists, getting ascites drainage and meanwhile living in fear. Today I will have my first chemo treatment.
At 9 o’clock a nurse calls me in. She shows me around the room. Today’s treatment will take approximately five hours. I see eight beds, small windows and a monitoring centre for medical staff in the middle of the room. Next door a small kitchen with coffee, tea and refreshments for patients. One toilet in the hall, one in the room. The nurse asks me to pick my bed for the day. Only three beds are occupied by elderly ladies, I guess in their seventies, but I have no courage to introduce myself as I feel frightened and tense about everything that is going to happen. The chemo, its infamous side effects, my deteriorating health, the unfamiliar setting. Completely against my nature, I keep my head down and quickly pick the bed nearest to the open standing door.
Next the nurse asks me to fill in a form and gives me a warm bedsheet. She also hands over an electric pillow to warm up my hands to increase local blood flow and ease intravenous infusion. She then gives me information about the procedure. I remind her that Finnish is not my first language, that I’m not familiar with cancer vocabularies and ask her to slow down her speech so that I can follow the instructions.
She continues, somewhat slower but doesn't check or re-check if I understand. It seems as if she avoids eye contact. She talks a bit louder and in a firmer tone about the pills that I should take. Six in total. I swallow them one by one under her observing eye. She tells me about the possibility of an allergic reaction. “You should flush the toilet twice and close the lid because of splashing chemical agents used in chemotherapy,” she explains. It crosses my mind that there is really nothing sustainable about cancer treatment.
Linguistically, I can follow the instructions but nonetheless there is something familiar and unpleasant happening during her monologue. Deep inside I have a sneaking feeling that she is not interested in me and my misère and that she just wants to give information in an orderly manner. While I try to listen, I completely freeze up. Halfway through her monologue my “yeses” and “nos” become affirmative nods. It only takes minutes before I fully shut down. I feel unbelievably lonely and desperate.
After the introduction, the bag with “Paclitaxel” is connected to the tube and the chemical enters my veins. Two nurses observe me for one minute, two minutes, three minutes. All of a sudden a heat wave starts from my breast, spreading over my face, I feel I cannot freely breathe any longer and start panicking. Instructions are given but I do not hear or understand. However, I realise that someone puts an oxygen cannula into my nose and that my bed is – bang! – dropped to a horizontal position. My vital functions, pulse and blood pressure are checked, and finally I hear someone ask if I can open my eyes. Six or seven faces look at me. I realise this was the severe allergic reaction the nurse had warned me of. “How do you feel?” the doctor asks. “I want to go home,” I say, staggered.
But going home is not an option.
The nurses give me an hour to come to my senses and luckily, the second trial with another chemo substance goes well. Around 13.45, I’m released from the ward.
*
Later that evening, on the couch with a cup of tea, I tried to make sense of what had happened that day. I couldn’t help thinking that the nurse overseeing my chemo treatment must have gotten a weird impression of me. I realised that I had fallen back into old behavioural patterns. Emotionally lonely people like me have an antenna for social rejection and exclusion and my antenna quickly picked up on what I saw as the negative signals from the nurse. Consequently, I did what I did during childhood: I detached myself and became aloof, meaning that I distanced myself from the nurse. She must have felt it and indeed distanced herself from me too. That is namely how the emotionally lonely unintentionally stave off people.
I also know that social cues can be misleading, especially when you’re hypersensitive or under stress. Maybe the nurse was friendly and open, but my foggy, fearful brain did not register it.
After a burnout, I got involved with the phenomenon of loneliness. With the help of a psychologist, I learned to analyse my feelings and recognise negative behavioural patterns from my childhood. I successfully managed to change behaviour and know darn well how to be forthcoming and friendly despite the negative signals I sometimes receive from others. I’m aware my brain can fool me, and I also know that I shouldn’t draw conclusions about others too hastily.
What’s more, I can ease situations, apologise or use my charm to get attention.
So why did my self-learned strategy not work this time?
Maybe the nurse could have acted more empathetic towards me. However, there certainly are things that I, a grown-up woman, could have done better. After talking to my therapist, I decided to call the ward to ask if my husband could join next time. They approved. Next, I plan to have a chat to express my feelings with the nurse before the needle goes into my veins. Nurses are trained to deal with the emotions of their patients, right? What also helps is that I'm now familiar with the ward and its routines. Lastly, according to my therapist, I can ask for an English-speaking nurse. I’m not sure yet if I need one but will keep the option open.
Mentally preparing for cancer treatment challenges seems to have an effect.
I feel much calmer about the next chemo.
