Love is the only thing that matters

Cancer, like pregnancy, starts out invisible to you or your loved one, then suddenly becomes invisible and visible. You'll notice a woman wearing a hijab walking on a treadmill at the gym instead of running. You will see an empty seat appear in your child's classroom, and the teachers will whisper and weep. Cancer is like pollen in the air in spring. We all breathe in this air, but only the wind can control where the pollen goes. And no matter how hard we try, cancer always wins. Half of us will develop cancer. Every two minutes, someone in the UK is diagnosed with cancer. It affects all of us.

The oncology ward is always very busy. The same is true of the oncology outpatient department, the oncology day ward, and the chemotherapy room. In the cancer clinic, some patients who come in for a test for the first time have to stand while they wait for the results. Rows of people lean against the wall, skinny, sweating, suffering from temporary, unknown pain. A room full of people waiting for the oncologist's diagnosis and treatment plan, praying that the general practitioner had made a mistake; The technician took a long time to repeat the scan without looking up at the patient, saying only that he was a little worried that the scan might have gone wrong; Others are praying that their sixth sense is nothing to worry about. A room full of people whose whole lives could turn around. The room seemed to have no floor, and the patients were suspended in mid-air, ready to fall into the abyss; Patients clutched numbers as they waited for the flashing screen above the nurses' station to jump from 73 to 98. There were no cups and no water in them. Empty buckets lined one side.

Day wards are always full; Because patients often have allergic reactions after their first chemotherapy, emergency calls ring out. This is a no bed room, with a row of chairs, walking back and forth between the nurses in each patient, stick chemotherapy drugs on heathcliff, mann (central venous catheter, for those who are desperately trying to save his sparse hair breast cancer patients who wear the protective cap, sent ice for serious oral ulcer patients, to ease their pain due to treatment.

Nurses have to handle cancer drugs that are cytotoxic very carefully. The earliest cancer treatments were developed during World War II, when nitrogen mustard gas developed by the U.S. Army was found to cause toxic changes in bone marrow cells. The Japanese medical community observed the complete destruction of bone marrow in the victims of the atomic bombings of Hiroshima and Nagasaki. Sidney Farber, a Polish-American Jew, was denied admission to medical school in the United States, as were other Jews at the time. He attended medical school in Germany in the mid-1920s, but soon returned to the United States to study at Harvard and marry Norma. Norma went on to become a children's writer and prolific poet. Soon after World War II, Farber discovered that aminopterin, a drug, could treat acute childhood leukemia by blocking a process associated with the replication of one cell. The discovery of this cell division block led to the development of modern chemotherapy drugs. I think both Farber and his wife are constantly searching for meaning.

Jane Cooke Wright is also searching for meaning. Her father was one of the first African American graduates of Harvard Medical School, and after graduating from an art school, she followed in his footsteps and enrolled in medical school, graduating in 1945. Jane Cook Wright discovered methotrexate, a widely used chemotherapy drug today. With this discovery, she saved millions of lives. Then, working with another scientist, Jewel Plummer Cobb, she went on to discover that methotrexate was equally effective in treating certain skin and lung cancers and childhood leukemia. But like Farber and Wright, as the great-granddaughter of a freed slave, Cobb suffered extreme racism. At first, she was denied a scholarship to graduate school at New York University because of her race. But fortunately for her, for them and for us, she got the scholarship after an interview. However, her experience in Michigan stuck with her: "Black students were not welcome at the grill or the pretzel tavern, so I was never allowed into mainstream life on a college campus."

Chemotherapy drugs are cytotoxic, that is, toxic to cells. Cancer UK describes chemotherapy as like using a sledgehammer to smash hazelnuts. Cytotoxic drugs work by eliminating, destroying or blocking cellular activity at specific points in the cell cycle, but they shatter everything. As well as treating cancer, it can also cause it. The chemo nurse will post a "Do not enter" sign at the door of the chemo ward to ensure that non-medical staff do not take unnecessary risks. Nurses wear protective gowns, double gloves, face masks and eye protection to ensure that no harm comes to them. Everything here has to be handled with care and handled with care. Chemotherapy drugs are like newborn babies. Spills of chemotherapeutic drugs are a major concern in hospitals, and some chemotherapeutic drugs are aerobic, meaning they can be inhaled. If the drug spills, is inhaled, ingested, or seeps into the skin, health care workers are at greater risk of developing cancer. This is the drug that we're going to put directly into the patient's blood. That's why chemotherapy patients can't walk within two days, vomit bile until they retch, and even discolor and smell -- they've been poisoned.

Marie Curie, a Polish immigrant to France (where women were not allowed to attend university), won two Nobel prizes for her discoveries of polonium and radium. Under her guidance, the world's first study using radioisotopes to treat tumors was carried out. Radiation therapy was born. Today, cancer is usually treated with a combination of chemotherapy, radiation and surgery. Of course, with advances in chemotherapy drugs, radiation therapy, and doctors' understanding of their use, cancer treatment and survival rates have improved year by year. We now understand the importance of careful handling of chemotherapy drugs and the dangers of radiation. Marie Curie herself had a form of cancer called aplastic anemia that year; She carried radium tubes with her, which gleamed in the pocket of her lab coat like the stars on the ceiling of a child's bed at night -- wonderful chemistry.

In addition to treatment, there are factors that can reduce an individual's risk of developing cancer in advance. Government health warnings advise against substances that may increase the risk of cancer: cigarettes, alcohol, burnt bread, cleaning products, pesticides, asbestos, which is used as a building material for school classrooms. But doctors sometimes can't figure out why a person has cancer. I've never been able to figure out why one of my vegan friends, who only eats organic food and doesn't drink or smoke, developed cancer. Another friend, who eats KFC, drinks cider and smokes weed, is unscathed. Why, while I was writing this book, a friend died at the tender age of forty -- a woman who had devoted all her time to helping others, but who had left a son younger than my own to die. As I get older and see more and more people with cancer around me, I can only remind myself to live a happy life and cherish the things that sustain us along the way: not material possessions, but love, kindness and hope. I try to remember that we can never tell which way the wind blows at any time. Marie Curie's father "enjoyed all the answers that could explain nature and the way humans behave," but none of us could really explain nature (Curie's husband slipped in the rain, fell under a carriage, and was killed by smashing his skull). Sometimes cancer is unexplained, like the cards handed to us by fate. But in the end, cancer reminds us of what's important.

I've been a nurse for 20 years. But it wasn't until my own father died of lung cancer that I began to understand the importance of kindness and deeper human nature and philosophy. When all other treatments -- chemotherapy, radiation and drugs -- have failed, hope leaves the room with oncologists, radiologists, technicians and scientists. Only the nurse at the bedside can offer him something -- dignity, peace, even love. Marie Curie's work did not stop after her death. Every year, about 40,000 patients with end-stage cancer are helped by Marie Curie's nurses -- people who have lost access to aggressive therapies.

Cheryl, my dad's nurse, was doing a nursing task I knew very well. She prepared the medicine according to the prescription. After washing her hands thoroughly, she puts on gloves and swabs the plastic tray with alcohol to make sure it's clean to prevent infection. Then she gently nudges the end of a small glass syringe bottle, inserts the needle and sucks the syrupy liquid into the syringe. She holds the syringe upright until the foam disappears from the bottom, then squeezes out the excess air. She was careful to check the patient before the injection and then double check the dosage. My dad's oncologist decided to take the current approach after considering technical variables and the patient's own circumstances -- differences in drug metabolism and liver metastases, peak plasma concentrations, opioid receptor binding profiles.

Before my dad's pain arrived, she would anticipate it, observe his body language, listen to the tone of his voice, notice the intervals between his words: the unspeakable. "I'm fine." He said. His voice was only slightly higher than usual. But she had talked to him and heard him so many times that she was fully aware. She sat quietly next to him for fifteen minutes, opening the curtains as the painkillers took effect. She knew that if the drug was given before the onset of pain, it might not work as well. She knew she needed to open the curtains until he could stand the light, so he could close his eyes and rest for a few hours. She knew how much time he had left, how much he needed to open his eyes and see my mom, and how much my mom needed to see him, and how much it would lighten her mood to see him.

Then I learned that nursing is not about completing tasks, but about how each nurse can provide comfort to patients and families in the details. It is a privilege as a nurse to witness the most vulnerable, important, and extreme moments of people's lives, and to try to love these strangers. Nursing, like poetry, is a place that straddles the boundary between metaphor and actual meaning. The defect of the heart is the defect of the heart; The nurse stands in between, between the surgeon's skill in repairing the actual disability and the patient's metaphorical disability of anxiety and loss. Nursing is -- or should be -- an act of unbridled care, compassion and empathy. It should remind us that we are capable of loving one another. If the way we treat our most vulnerable is the measure of our society, then care itself is the measure of our humanity. Yet it is also the most underrated occupation of all. But anyone who has fought cancer can understand and appreciate the value of care, and perhaps understand that, in the end, cure -- which is often impossible -- is not the most important thing.

In 1989, the Nobel Prize in Physiology or Medicine was awarded to J. Michael Bishop and Harold E. Harold E. Varmus, "for their discovery of the cellular origin of retroviral oncogenes". Valmers was a scientist who was later promoted by Barack Obama to head the American Institute for Cancer Research. In his Nobel acceptance speech, he quoted "Beowulf," and what he quoted made me think about Cheryl, about what cancer care is, and how important the light and heat that a nurse radiates is: "More than a thousand years ago, during a long and arduous life, Beowulf taught people the importance of the Scandinavian halls -- the gathering of light, heat and vitality that make these buildings comfortable in the endless darkness of winter, cold and the imminence of death.

Palliative radiotherapy is like hammering nails into the coffin boards with a spoon. The body is disintegrating, trapped in a dark coffin, but not ready to be buried. Palliative radiation therapy is sometimes used for symptom control. The tumor may press on the trachea and cause the patient to suffocate and die. Palliative radiation therapy can suppress the tumor and cause death to occur in a different way. A more acceptable way to die. A better way to die than letting nature take its course. The phrase "natural death" is thrown around hospitals, as if dying of natural causes is something to be enjoyed. But that's not the case. Natural death from cancer is anything but natural and can be terrifying. The body begins to decompose, giving off a rotten smell, slowly rotting, swollen and twisted veins, sweating until it oozes like cheese melted by the sun after a picnic. Natural death is perhaps the cruelest torture, and palliative radiation therapy, while also grueling, is relatively less cruel.

My dad was on the edge of life, but very slowly. Still, he yearned for one more hour, one more second. He had taken so much tramadol that his vision was blurred and he had difficulty staying awake for long periods of time. But when he is awake, he goes to the beach with his mother to watch the waves, the sun and the birds. In the last months of his life he saw more sunrises and sunsets than he had seen in the first sixty-three years of his life combined. Sunrise and sunset become important. He was on palliative radiation therapy, and I was worried. I wanted him to always have the sunset in his eyes, so he could always hold hands with my mom. I wanted to smell him, to put my head on his shoulder, to bury my nose in his pullover, to feel the breath of each other -- a thousand memories and years. I was in my thirties when I sat next to my dying dad. But I was four years old again, leaning on his shoulder, asking him to point out the stars and tell me their stories. Then, at 14, I broke up with my boyfriend, who held me while I buried my head in tears. I had never seen him happier before or since I held my daughter and showed him in my 20s. That's all I want.

On Christmas Day, we went to the seaside. Usually, after Christmas lunch, we push aside the chessboard we were supposed to be playing and have a good sleep on the sofa, leaving our cups and plates in a mess. But this is Dad's last Christmas. We know that because chemotherapy, palliative radiation and steroids have stopped working. We know that.

It was cold by the sea; Dad's lips are almost blue. He was afraid of cold. Once, he wore a jumper in the Sahara Desert, though it was "a bit prickly." And it's winter, and this is the Irish Sea, and the people who come to see it are a bunch of old bones. But I want to take some more pictures. I fidgeted with my big camera with mock composure, pretending to look for shells, secretly snapping pictures of him and capturing the color in his eyes. As the light changed, his eyes changed from grey to blue and then to green.

I wanted to capture the color of his eyes, to capture more moments. Palliative radiation might give me another day, or a week, or a month. But I don't want to spoon in his coffin. It's too slow. His eyes will lose their sparkle. He'll be incontinent, he'll be in pain, he'll ooze fluid. I've seen too much, and I can't avoid it. We don't need a war or a tragic traffic accident to remind us how terrible life can be. Cancer is enough.

"Come up." My dad pulled back the curtain and motioned to Cheryl.

She smiled, a hearty laugh, and went back to writing her journal. "Shame on you."

They smiled at each other.

It was my dad's last day on earth, and neither of us knew it, but Cheryl did. When he chose to go home, she followed, keeping watch around the bedroom, occasionally coming down for tea or a phone call, or giving us space when I came in to visit; But when my brother or my mom would go in, she would go in with her. She didn't discuss anything with me about nursing. Today, I'm the daughter of one of her patients. She used to put her arm around my shoulder and let me out when she was helping my dad use the toilet. In the corridor, I could hear them whispering and laughing.

I sat next to my dad, watching him and Cheryl and their interactions, trying to think about the meaning of the nursing work I had done all my life. Mom and brother are downstairs. I imagined that my mother must be crying in my brother's arms. Cheryl nursed my dad longer than ever. I looked into her eyes, but I couldn't bear to look at Dad. He was never big, and cancer made him even smaller. His skin slouched over his limbs, and he was a different color, not yellow, but sallow, with a gray haze around his sunken eyes. He can't hear. Now he needs a hearing aid. He yells at everything he says. He can't taste it. That's the worst part. "I could be dead. I don't know what dinner tastes like." He likes to read food magazines, though he never follows the recipes: steamed Moroccan lamb, cheese souffle, Cornish turban with celery in bone marrow bisque, French onion soup. "You know, I've never cooked coq au vin in my life, not a single meal." 'he exclaimed.

"But you've made French orange duck," Cheryl responded. "Cut down on the blackberries. It's all the same. You told me about your craft. You've cooked some amazing dishes."

I told Cheryl about our childhoods, returning to our modest home in Stevenage, finding the pheasant my dad had brought home to hang on the doorframe, or bringing friends home to play and finding my dad cooking lamb's heart sweetmeats, or him going to the side order every night to pick out our vegetables for the evening. My brother and I hated scrubbing carrots when we were kids, and longed to see them in cleaner, more pesticide-laden plastic bags around the house. While I was talking, Dad was groggy, sleeping and waking, waking and sleeping. But his interesting sleeping position was the same as usual: his arm suspended in mid-air, his hand resting on his forehead, although he woke up every time it dropped. He was mumbling, his breathing steady.

When I finished speaking, Cheryl looked at him, then at me. "I think it's time we sent your mother up. Come this way."

I don't want to nod. I don't want to know what Cheryl's implying. Dad was on his last legs. I could see that his breathing was slowing down, that he was getting restless and then not moving. But I'm not ready to let him go. I'm not ready.

"It's nice here," she said. "It's a nice day."

The curtains were half open - the sun would make Dad's eyes uncomfortable. But I could see the sun bathed in a golden sky and a flock of birds dancing in the clouds. I can hear the seagulls on the roof.

Dad's at home in bed. He's leaving. My mother held him, my brother held him, and I held my mother. There is no pain now. There is only dignity. There is only comfort. I can't imagine a better exit. We have plenty of time to finish our sentences, or we can shut up about the unspeakable. She had time to look at him, and he had time to look at her. We cried, and then we laughed. He held his life in his hands until the last second. Turns out Dad did a pretty good job of passing away. It was my mother who taught me how to live life to the fullest: with joy, affection, tolerance and truth. But Dad taught me how to make a graceful exit. He left with humor, dignity and a complete lack of fear. Although his body shrinks, his soul slowly spreads out, until it fills all the air of the world.

But still, I was afraid. I watched Dad's breathing grow slower and more futile. I wanted to push my mother and brother away, to press his sternum, to get his heart pumping again, to do what I had been trained to do, to use all my strength, to bring him back to life like so many others I had helped. But I can't help my father. Because today, I'm not a resuscitation nurse. I'm not even a nurse. I'm a daughter. It was painful. Everything is painful.

I looked out the window and held my mom as tight as I could until she stood up and my brother held her. At this moment, the sky had changed from gold to the deepest and most incredible blue. There is no moon in the sky. I leaned my head on my dad's still chest, trying to hear his heartbeat. There's nothing left.

Within a few days, I was back at work. I was numb. I feel cold all over. "If I don't come back now, I may never come back." I explained to my supervisor that she was worried I was a little early. But the first emergency call I got that day was to oncology. The oncology ward is quieter than the rest of the hospital. The nurses were slow and thoughtful, and spoke in hushed tones. There were more family members here, in small groups, their eyes puffy and their coats on. There were about ten wards on either side of the corridor, followed by a small nurse's station where members of various specialist teams could browse through an incredible array of medical records. Busy here are pain relief teams, infection control nurses, tissue activity nurses, physiotherapists, bereavement care specialists, hematologists, oncologists, radiologists... The hospital chaplain went in and out of the ward, praying for atheists, agnostics, Muslims, Christians, all living good and bad days.

To the left of the nurses' station is another long corridor leading to the main ward area, where beds are separated by curtains and family members sit on plastic chairs of thin, dying, mostly balding patients, their bodies shrinking with cancer, attached to drip racks and syringe-driven devices that deliver morphine. Down the hall is a family room where doctors and nurses come to deliver bad news. They are here as professional as they can be, and they understand that straightforward language is the only language people understand when they are numb and cold. "Your husband passed away last night, I'm sorry" is never replaced with "He passed away peacefully in his sleep."

Nurses make phone calls and urge families to come to the hospital while assessing the likelihood of accidents on the way. "Can you come this morning? She's stable, but I thought you'd be here by now."

They can always tell empirically that time is up, regardless of the results of their observations or clinical blood tests. They use their experience of talking to thousands of family members of patients to determine how they should speak to get them to the hospital safely and quickly. If they find the family unable to do so, they will ask the local police to deliver the information in person and ask them to assist the family to come to the hospital. A senior nurse once told me that of all the documents in oncology, the most important document is not the blood pressure record, the diagnosis or the treatment plan, although these are important too -- the most important is the contact information of the patient's family. "Never forget to write down your phone number clearly." Not being able to reach someone in time is probably the most heartbreaking thing.

"We need to do sustained chest pressure: more than two minutes." "Ronald said. As the nurse in charge, she knew that the patient's family would be at least two minutes away, and she knew her husband well enough to know that it was extremely important that he be by her side when the patient died. Ronald told junior doctors to keep pressing, even though senior doctors had advised them to stop. "Another round," he said. "Her husband will be here soon."

Ronald knew that at that moment, "She's dying" was more comforting than "she's dead." He knows that for many of his patients, even though the outcome can't be changed, a small act of kindness may make a living loved one feel better. Illness is never just about individuals. The husband won't remember the doctor's persistent chest compressions. As the weeks, months and years passed, he would forget the cruelty of the resuscitation treatment, the blood, the needles, the violence of pressing on such a fragile body. But he will always remember holding his wife's hand as she lay dying and whispering to her what he needed to finish.

I bustled around the ward, trying not to look too closely at the patient, but that was impossible. In a way, they were all too much like my dad: the same hospital gown, the same dry cough, the same untouched fruit at the head of the bed, the forced smiles of the wives. Gritting my teeth, I followed the medical team into the side room, where a man was sitting on a bed with an oxygen mask over his face. A doctor came out and took off his gloves. "False alarm," he said. "They thought it was an allergic reaction, but there was nothing wrong with him." One by one, the group left, but I stood where I was, unable to move. I was left alone with the patient. He pulled down his oxygen mask and smiled at me. "You got a minute?" He asked.

"Of course." I sat beside him and brought him the newspaper he wanted from the next bed.

"Can you read me the battle?" He turned the paper to the racing section. I had a mountain of desk work to do and a training session to attend soon. "Just a quick read, I don't want to bother you, but I can't see a word without my glasses."

I read out the names of the horses and the rankings.

He listened and drew in the air. "That guy." He said.

I didn't look up from the paper. I could smell the metallic smell of the chemotherapy drugs on his skin and hear the ticking of his water. What bothers me are the slippers, which are neatly arranged under the bed. They're just like my dad's slippers.

I suppressed the tears for a few days suddenly broke out, tears come too fierce, I accidentally overturned his bed of a glass of water. "I'm sorry," I said. "I'm so sorry."

I got up to leave, but he grabbed my arm. He pulled me into a chair and sat me down, and I cried. He pulled me towards his arms and held me close to his crunching chest. His ribs pressed against my cheekbones, and my tears flowed fast and freely. It was only a few seconds, but I thought it was longer: he became my nurse, and I was his patient.

"Cry it out, girl."

"I'm sorry, that's not professional. I'm here to help you."

"Nonsense," he said. "We should all help each other."

I cried and cried and cried and cried. At the same time, every cell in my body hoped that this patient who was holding me, who was dying of cancer, was my dad.

Cheryl was at my dad's funeral. She stood at the back, near the door, away from family and friends, trying not to be noticed. But as I stood in front with my arms around my mother and the children crying beside me, I still saw the tears in her eyes.

My brother thanked Cheryl in his speech. "She let him go with dignity, without pain, as he wanted. In her final days, she fulfilled her mother's request to have her father admitted to the hospice ward. She brought the whiskey to the hospital room to give dad what he wanted. Whenever I text her from London, she replies. When she knew it was the last moment, she stepped into her role. She was a nurse by profession, of course, but she did much more than that. To my family, she was a nurse to all of us. To Dad, she was a friend. She loves him, and he loves her. '

By the time I stood up, my legs were fighting. I walked to the podium, trying not to look at my mom, or imagine my dad lying in his coffin in front of me. I've never been short of words, but today I don't know what to say. So I read Dad's words -- and Cheryl helped me find what he had written. Cheryl supported him in planning his funeral and figuring out what he wanted. She also helped her mother make plans. She told her mother that officially, you need official permission to be buried at sea, but my mother said she knew a big fisherman who could ignore the rules. "Ian would have liked a man like that." "Cheryl said.

When I read my father's words, I did not look at my mother. But I kept looking at Cheryl's face. I don't know how to say this. My voice broke. But the tiniest nod from her gave me the strength to pick up my speech, stand up straight, and read it out:

"Love is the only thing that matters. I'm talking about all of us: the love you share with your wife, or with your husband, your lover, your son and daughter, and -- perhaps most precious of all -- with your grandchildren. I'm talking about a love so deep that you can give up your life to defend it. A love so high that you can see heaven, high enough to believe in it. Maybe some of you have seen it. Maybe some of you are lucky like me. That's all I want to say. To love. In the end, love is the only thing that matters. Love each other."