Fabrizia Faustinella“At the temple there is a poem called ‘Loss’ carved into the stone. It has three words, but the poet has scratched them out. You cannot read loss, only feel it.”
Her mother told me that she finally fell asleep and had a dream, where she saw two of her daughters, who had already died of cancer, and then saw Riney joining them. They all had white dresses on and looked young and happy. Riney smiled and waved at her.
“Goodbye, Mama,” she said, and then started fading away.
She woke up in a sweat and knew in her heart that Riney had passed away. Then her phone rang. It was a call from the hospital to notify her that Riney had died.
That’s how it happened. She started losing weight and her skirts became loose, almost falling off her hips. She would keep them up with safety pins, under her apron. She worked in the physicians’ dining room and made sure that everything was in perfect order and everybody was well taken care of, like guests in her own home. A good woman, kind and thoughtful, with a lot of common sense, a rare quality nowadays. A fighter too. Somebody who did not have an easy life and had to work hard for every little thing she got. She was brought up in a large family in Mississippi.
I liked going to the dining room because of her. I would hide in a corner, hoping that nobody would see me, as I didn’t like having to talk to some of my colleagues at lunchtime. But I loved for Riney to sit down with me and chat. She would make me smile, tell me funny stories, and put me in a good mood. She would tell me sad stories too, like the story of Emmett Till. She told me that his tomb was vandalized, and I felt sorrow for the hatred the human heart can harbor. She told me about one of her sisters dying of colon cancer and how, after that, she went to get a colonoscopy and, thankfully, everything was good. She told me about her ninety-four-year-old mother, who used to pick cotton in the Mississippi plantations for a few cents a day, since a very young age.
But she never told me about her son, so I’m not at liberty to tell you either, even if now I know what happened to him.
Some of her coworkers in the dining room told me that they noticed Riney losing weight and coughing. Initially, I didn’t pay much attention to it. I thought she was on a diet, because she was always concerned about being fat and often asked about weight loss advice. She wasn’t fat, really. She had very large natural breasts, and that made her look bigger than what she really was.
I knew, though, that Riney was a smoker, and I had told her to quit so many times! So I asked her if she’d had a chest X-ray done in the past few months. She wasn’t one of my patients, but I cared about her, a lot. Therefore, I kept on asking about this chest X-ray and, with some reluctance, she told me she had had one within the past year. She told me that her employer, the hospital she worked at, required her to be checked every year. I knew that she was supposed to get a PPD every year, the screening test for tuberculosis, but certainly not a chest X-ray, unless the PPD was positive. I didn’t press her for more specific answers, as she seemed to be somewhat avoidant.
Then I left town and came back three weeks later. As soon as I stepped into the dining room, I was told by her coworkers that Riney was in the hospital with bad pneumonia and that things didn’t look good. A cold shiver went down my spine. I accessed the electronic medical records system, even if I knew I should not have done it, as I was not involved in her care. I looked up her chest X-ray and CT scan.
There it was, a large, ugly mass, a cancer, a malignancy, the type that smokers get, spreading already, everywhere. A death sentence.
My heart sunk. What could have I done differently to keep things from getting to this point? When it was brought to my attention that she was losing weight, should I have been more forceful with her, pushing her to get a workup? Should I have asked her to come to see me in my office? Should I have done something more, besides inquiring about the chest X-ray?
It was too late now, and I felt awful. How could I have not been more insistent with her about getting checked?
That thought kept on swirling in my head while Riney kept on hoping against hope that she would make it. She knew it was bad and she was desperate for hope.
One day, I went to visit her in the hospital, where she was receiving chemotherapy. She looked straight into my eyes with an unusual intensity, pleading for good news, pleading for hope.
I sighed, tears streaming down my face, and I must have looked defeated, because that’s how I felt.
At that point, Riney said to me, with pain in her voice, “Don’t do this to me, Dr. F.”
I realized then that she didn’t want to see me crying, because that was the unmistakable sign that there was no room for hope, and I’ll never forget that. Displaying my true emotions was hurtful to her. I thought then that we have to stay strong, no matter what; not in the sense of creating false hope, but in the sense of not betraying our most inner feelings in order to leave room for hope, when people are desperate to hold onto it.
Riney started chemotherapy in October and passed away at the end of January. She fought her battle during the winter months, and even in the gloomiest of days, she never stopped hoping that things would, somehow, change and turn out all right. She never stopped hoping she would see other springs in her life.
After she died, I avoided going to the dining room. I knew all too well that I was going there because of Riney, not because of the food. There was no reason for me to keep on going, if Riney wasn’t there to sit down with me and talk to me. Everything felt so different, and I couldn’t bear the emptiness of it all.
Riney was planning to retire in a couple of years and start traveling. “I’m going to have a good time,” she used to tell me, “I’m going to go to Italy,” and then her life was over like that, within five months, all her dreams gone with her, and a part of me gone, too.
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