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A Dying Nurse Asks: Just Dig A Little Deeper

January 17, 2013
Written by: , Filed in: Abdominal Imaging, Emergency Radiology
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This story has only a little to do with radiology, but a lot to do with kindness and generosity and courage, and especially with remembering that health care is about treating not illnesses but people.

Or, as Martha Keochareon put it, “Just dig a little deeper—you know?” Reporter Abby Goodnough told Keochareon’s story in a New York Times article last week

Koechareon (pronounced CATCH-uron) was a nurse. In November, she called her alma mater, the nursing school at Holyoke Community College in Holyoke, Massachusetts. “I have cancer,” she said, “and I’m wondering if you’ll need somebody to do a case study on. A hospice patient.”

For several years, she had felt increasingly sick. She suffered a burning sensation after eating, abdominal pain (which doctors dismissed as psychosomatic), and itchiness. She also developed diabetes. Finally, in 2006, when she was working at a hospital in Charleston, South Carolina, a CT scan revealed that she had pancreatic cancer. She was 53 years old.

Six years later, having far outlived her doctors’ most optimistic prognoses, she was living in a small house in South Hadley, Massachusetts, not far from the school. She was bedridden, nearing the end. But she thought she could still be of service—could give nursing students the rare opportunity to examine and question a cooperative, knowledgeable patient during the end stage of life. Besides, Koechareon said:

When I was a nurse, it seemed like most of the other nurses were never too happy having a student to teach. I loved it.

So two first-year students began visiting her regularly. “Sit on my bed and talk to me” she said. They hesitated. They had been taught not to, to prevent the transmission of germs. Eventually, the students learned to practice what Kelly Keane, a counselor at the college, called “therapeutic communication.”

Said Keane, “The way we’ve learned in school, and haven’t applied enough, is just saying, ‘I’m glad to be with you. You must be frustrated. You look uncomfortable.’ And let the patient just talk and talk and talk, and see where they’re at.”

Koechareon was in considerable pain. The cancer had metastasized. She had tumors in her bones and around her throat. But, at her request, the students kept visiting. They noticed the exhaustion of the family members helping to care for her. “The patient isn’t Martha per se,” Keane said. “It’s the entire family.”

After about a month, the pain was getting worse. Koechareon showed one of the students her portfolio, with her resume, nursing licenses, and letters of recommendation. Learning from books, she said, was good. Learning from patients was better. “When you look back, you associate a certain person with a certain diagnosis.”

She also apologized:

I’m sorry I went downhill so fast. I thought I could teach more.

Nine days later, Martha Koechareon died quietly in her bed, with her husband beside her, as the first snowfall of the season was decorating the landscape. She was 59.

Related seminar: UCSF Abdominal and Pelvic Imaging: CT/MR/US


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