Harvesting the Journey: Embrace, Empower, Endure

Embrace: to accept As a pediatric palliative care nurse practitioner, I journey with patients and their families through the toughest of diagnoses, including disease-related pain and symptoms. I sit with them as they receive good and bad news, including conversations leading up to the last breath. As I reflect on the work I do, the word embrace takes on a much different meaning. One of the favorite stories my husband Andy and I loved to share, was how we met. I am forever grateful to my mother-in-law, Joanne, not just for her resiliency and strength, but for introducing me to the man of my dreams. I worked as a patient care tech on the same hospital floor as Joanne. I begrudgingly agreed to share my email with her after she thought we would be a good fit. After a few weeks of emailing over winter break, we agreed to meet in person. He walked into my college apartment wearing what we soon would refer to as his “white snake jeans”, brown trucker shirt, and black shiny shoes. Obviously, it was not his wardrobe that won me over but his calming and reassuring voice. It was that same voice that asked me to be his girlfriend on February 2, 2005, his fiancé on June 1, 2009, his wife on September 18, 2010, and rejoiced as he shouted, “It’s a boy!” on October 20, 2016. It was his voice I heard as we shared many adventures. Throwing pennies in the Trevy fountain in Italy, drinking wine in California and Guiness in Ireland, eating olives in Greece, ziplining in Costa Rica, hiking Denali (sort of) in Alaska, visiting ground zero in New York, dancing at Señor Frogs in Mexico, touching the Golden Toe (he did) in Croatia, skiing in Colorado, and cheers-ing in unique breweries across the US. Andy, my strong, funny, fierce, cool, calm and collected husband, was diagnosed with stage 4 colorectal cancer in January of 2017. To say we were in shock is the understatement of the year. How can this be, the medical professional in me kept asking? I kept reviewing the timeline of events. He had back pain from his golf trip but clear x-rays. He was constipated from the pain meds. The blood in his stool was from hemorrhoids. The MRI showed herniated and bulging discs. In medicine, you could call it the perfect storm of events. It was also just three months after Andrew was born, hence the rationale for his fatigue. I recently read that 56% of those diagnosed with colorectal cancer saw at least two doctors before being diagnosed. We saw four. When Andy’s journey began, doctors thought his herniated and bulging discs were the source of his pain. It was not until efforts to treat the discs were unsuccessful, and the pain started to increase severely, that he underwent additional testing. This resulted in discovering cancer. Andy immediately began aggressive chemotherapy. Empower: to give strength In my professional role, I am passionate about empowering patients and their families to ask for what they need, to think about their goals, and to let them know that hope is always alive.  My husband brought that home for me. Despite the severe pain, emergent ostomy placement, infection, and time in the hospital, Andy fought hard to remain the most optimistic, energetic, and passionate person we knew. Prior to his diagnoses, Andy left corporate America to begin his dream job as an assistant brewer at Rock Bottom Brewery and cancer did not stop him! Andy’s zest for life was contagious to those that knew him. Though he was the sickest in the room most days, he continued to be interested in those around him and empowered them to be the best version of themselves. He inhaled life and exhaled love in everything he did. He taught us what passion looked like for work and everyday life. He instilled kindness in all things even during the hardest days. Many who knew my beloved husband were privy to the fact that he made a damn good beer. I am re-grounded by his passion for hard work almost daily as I pass by the pop-up craft breweries and see marketing for hopped-out beers. However, I believe his greatest accomplishment was becoming a father. He gave life to one of the coolest kids we have ever met. Though my heart is full of our adventures and traveling together, the daily reminder of Andy is our son, Andrew. He is his finest gift of all. Endure: to withstand hardship I am humbled by the strength and grace of the families I see at the hospital.  When a child dies, we see loved ones come together, remember their little one, and begin to create a legacy that will live for years to come.  My Andy was the definition of strength and grace, and I am grateful to be a part of his legacy. Andy died September 13, 2017. A saying Andy used that will forever stay with me was from Bob Marley. It was “Evil never takes a day off. So, how can I?” He dealt with unimaginable adversity as a true warrior, followed his life passions and goals, and accomplished them with grace. I cannot say that I am not lost, confused, angry, and sad. I will say that Andy would want us to harvest good just like he harvested his hops. I miss his daily Seinfieldisms, unique movie quoting, calm demeanor, protective nature, and telling me the sun will shine tomorrow. Most of all I miss his voice. Never in a million years did I think my career would help guide me through my darkest days. It did not make it better, but I came back to work with a new understanding of what my patients and their families go through. Yet another gift from my Andy. His legacy will live on.   Meggan Mikal is a pediatric palliative care nurse practitioner, mom to Andrew, and wife to her late husband, Andy