A Promise for Keeping

"You're getting too close Eric. That's not good," she rose from her desk and stood beside me. "Look, I am not accusing you of anything. You are one of my best nurses. I know you would never mishandle a nurse-patient relationship, especially with a married patient, but you are simply getting too close."

She returned to her desk before adding, "You know she is out of remission."

"Of course I do," I said softly.

"She is very sick Eric, the odds are not with her. Her prognosis is grim. We see this every day, you know what happens. I do not want to see you get hurt."

I returned to my work, accepting her decision, but once my shift was complete, I went to visit Alison.

"I thought you weren't allowed to take care of me anymore?"

"They can tell me that I can't be your nurse anymore but they can never stop me from being your friend."

"What about Brian?"

"Alison," I answered with a question of my own, "Do you want to continue being friends?"

"Yes," she said with her sad eyes.

"Then it's our decision, no one else's."

We decided then that we would not allow anyone to prevent us from remaining friends. We also agreed, however, that it would not be wise for me to be around when Brian was visiting. That did not matter much though as he was, much like her previous admissions, rarely around. Some nights, I would drive by their house late only find it vacant, cloaked in darkness, his car not in the driveway.

Alison's third visit to 6 North was, as expected, much like her first: thinning hair, low blood counts, daily transfusions, nausea, infections. The only thing different was that I was not her nurse.

I would check on my friend frequently. On the rare occurrence that Brian was in, the nurse caring for Alison would alert me and I would keep out of his sight. On days we would not get a chance to talk, Alison would often write me brief notes, leaving them with one of the nurses for delivery. At days end, those notes would always find their way into the small cardboard box by my nightstand.

One day, four weeks into her stay, I found her sobbing miserably in her room.

She was again on isolation and I was cloaked in gown and gloves, a mask concealing my face. Seeing her so sad, I wanted nothing more than to hold her but I knew could, and should, not.

"Alison, what is it Hon?"

"He's leaving me Eric. He found someone else."

"Who, Brian?" I asked. "What are you talking about?"

"He came in today and told me, right here," she said in a very sad, low voice. "He met a woman at work. He told me he has been seeing her for a year now and that it is all my fault."

"You know that's not true Alison."

"He said that if I had been there to take care of him, it never would have happened. He said he is going to move in with her now and that when I am better, he wants a divorce."

"That is the most cowardly thing I have ever heard. Don't you dare believe him Alison, not for a second."

"He said I'm only sick because I'm not strong like him," she was just staring blankly out the window.

"That is not true, Alison."

Finally, she looked up at me. "I know Eric. I know that now, because of you."

And with that she broke down, the hardest I had seen her cry her entire illness. Before I could stop her, she reached out and placed her small head against my chest, the floppy beret she had resumed wearing falling to the floor.

"Make it go away, Eric. Make it all go away."

I caressed her tiny head, hairless once again, with my gloved hand saying nothing, only listening to her heartrending sobs, wishing I could do as she requested, fighting back tears of my own.

Things were very different after that. Without Brian around at all, I could now visit Alison whenever I felt and would do so everyday, including my days off. Things were also better in that Alison's health was slowly returning as her bone marrow began recovering from the chemo's deadly assault.

Within two weeks, Alison was doing remarkably well. Her spirits were high and with the exception of her platelets, so were her blood counts. Sometimes, when a patient receives as many blood or platelet transfusions as Alison had, the body begins creating antibodies against the foreign cells. Over time, Alison's body had produced so many antibodies to donor platelets that despite how many units we would give her, her counts remained at unsafe levels leaving her blood too thin to clot properly. What this meant to Alison was that even though she was feeling better, she would have to remain with us on 6 North for a few more days until her marrow could produce enough platelets of her own that she would no longer be at risk of bleeding.

That was fine with me, and as she was not looking forward to going home to an empty house for the first time, it was OK with Alison as well.

We decided to celebrate what we called 'A few extra days on 6 North' with a pizza party during my dinner break that evening.

We enjoyed our pizza but as usual, enjoyed each other's company even more. The sterile gowns were gone and it was nice to be able to sit near her and touch her without a gloved hand.

"I'm feeling so much better," she said as we ate. The color was returning to her face and her eyes did not look nearly as sad.

"You look much better," I replied.

"I mean inside," she said tapping the area above her heart.

We sat quietly for sometime and without warning, she reached for my hands.

"Promise me, Eric. Promise me I am not going to die."

Rule number one of oncology nursing is to never make promises. Accepting Alison's small hands in mine, I brought them to my chest. Holding them over my heart, I broke that rule. "You are not going to die Alison. I promise."

She smiled with a small tear in her eye and kissed away the one that had fallen down my cheek. I smiled back and kissed her hands. I wanted to tell her right then that I had fallen in love with her and that no matter what, I was willing to see this thing through, but I had already broken one rule of nursing that night and did not feel that this was the time or place to break another.

"Hey, I have a shift to finish here," I said looking at the clock on the wall. I got up to leave but Alison held on to my hand for one extra second and if ever anything were ever going to be said between us, it would have been right then. Before either of us could speak, her door opened and Robin, Alison's nurse for the night, who was beginning a twelve-hour shift, entered the room.

I squeezed Alison's hand gently and told her I would stop in after my shift to say goodnight. Robin smiled at me, almost knowingly, as I left the room.

By the time my shift was complete, Alison had fallen fast asleep. I did not have the heart to wake her and instead, stood silently at the foot of her bed, admiring her angelic face in the moonlight that shone through the window and I whispered under my breath, in a sort of wishful prayer, that it would not be long until the time would be right for the two of us to be more than just friends.

As I punched out, Robin asked if I was working in the morning. I said no but added that she still might see me anyway, as a visitor, and she smiled as I skipped off the unit and onto the elevators.

That night, I dreamed of Alison. In my dream, she was anything but sick. Her body was strong and cancer-free, dressed not in a sterile hospital gown but a magnificent evening dress. Flowing and white; it fluttered in the wind behind her like the wings of a butterfly. Her own auburn hair grew freely and it spilled across her shoulders as we ran together, hand in hand, across the sands of some far away beach so breath taking, it could only be envisioned in a dream. We laughed and touched and kissed, unashamed and unafraid of deadly bacteria or jealous husbands.

In my dream, we fell to the sand and into each other's arms, her dress spilling open to reveal only her beautiful breasts - free from catheters, clean of surgical scars. I brushed the hair from her lovely face and we kissed as the orange sun fell asleep and the sky was claimed by a brilliant white and full moon. Clothed only in silver moonlight, we made love as warm tropical winds enveloped us like a blanket.

"I have fallen in love with you Alison," I confessed to her in my dream, bringing tears to both of our eyes.

"Now, I will never die Eric," she said as her hand rested gently on my chest, directly over my heart. "Because I will always live here."

Because, I will always live here.

I awoke that morning with a renewed sense of urgency. What was I waiting for? Her husband had left her; I was still no longer allowed to care for her. What did I have left to lose? If my love for Alison raised some eyebrows around the hospital, well then to hell with them. I dressed quickly and headed for the hospital.

Robin saw and tried to stop me as I made my way to Alison's room, but I was a man who would not be impeded. I entered her room only to find it empty, the walls striped of her pictures and cards, her bed vacant. They couldn't have sent her home already, I thought to myself and before my brain could imagine the only other reason why she would no longer be in her room, I felt a hand on my shoulder and turned around quickly to see Robin before me with tears in her eyes and Alison's purple beret in her hands.

"Don't you dare tell me she's dead Robin," I pleaded. "Don't you dare!"

"She's not dead Eric, but she..." Robin looked into my desperate eyes, almost apologizing, "she bled sometime during the night. I found her unresponsive early this morning, barely breathing. I called a code and we saved her, but the CAT scan showed a massive intercranial hemorrhage."

Without enough platelets in her tired body, Alison's blood had become so thin that she spontaneously bled into her brain, sharing the fate of so many leukemics before and after her.

Robin wrapped her arms around me but I could not respond. I just stood there, numb, dying. "I'm so sorry. I know how close you were. They brought her to intensive care and they're waiting for her family to arrive before... before they withdraw life-support."

"I love her Robin," I finally managed weakly, staring out at nothing at all.

"I know Eric," Robin said as she placed Alison's beret into my trembling hands. "And she loves you too."

I looked at her, taken aback. "She told me," Robin confessed, smiling between her tears. "Last night, after you left. Go be with her Eric. She would have wanted you there."

I rushed up to the intensive care unit on the ninth floor and, out of breath, checked in at the nurses' station where I, even as an employee, had to request authorization before seeing a patient.

"There's been a restriction placed on visitors for Mrs. Lumm," I was told by the nurse on duty.

"By who?" I asked confused.

"By me."

I turned around to see Brian hulking over me.

"What are you doing here?" I asked angrily.

"Watching my wife die. What are you doing here?"

"I came to go say goodbye to my friend," I responded as I tried to push my way past him, fighting back the tears that were beginning to fill my eyes.

He grabbed me around the shoulder and pulled me back. "No one sees her, except her parents when they get here."

Legally, he had every right to forbid me from seeing her. I could not fight him on that. I tried one final plea.

"Please Brian. Please let me say goodbye." The tears were beginning to flow freely now. Softy I added, "Please, I love her."

This infuriated him and he raised his fist, bringing it down hard on my jaw. I fell to the floor, blood spilling from my mouth. The ICU nurse picked up the phone but I asked her to stop knowing she was about to call security. Brian was standing his ground, fists clenched. I slowly rose to my feet, wiping fresh blood from the corner of my mouth with the back of my hand.

I stood no chance against this giant and I was not about to try. That is not what Alison would have wanted. With her in mind, I lifted my hands in surrender. He would win, but I still had something I wanted to say.

"You never once realized what you had, did you?" I said backing away.

"Get the fuck out of here!" he demanded, fists still raised.

"She did love you Brian. And it is so sad that you don't even appreciate what a precious gift that was." I continued to back away, blood trickling from my mouth, tears falling from my eyes.

"I said get the fuck out!"

I swallowed hard and was about to turn and leave when I decided there was one more thing he needed to know. "I do love her Brian, and she loves me too. And you can never take that away from me."

He did not respond, he just continued to stare me down with his ugly, hate filled gaze. In time I would learn to feel sorry for him but at that moment the only thing I was capable of feeling was the bitter throbbing of my fractured heart. I turned and walked away.

The first door I came to lead to a fire escape stairwell. From nine stories up I began a rapid descent, my sobs and footsteps echoing off the walls, until I lost my footing and fell, my body tumbling through the air before landing hard on a guard rail, dangling over the edge, staring down seven stories of openness. I watched as a drop of blood fell from my mouth and disappeared into the darkness below. For a moment, I saw myself climbing over the guardrail and following that lone drop through the shadows and into the concrete floor that awaited me beneath.

What a fitting end to this tragedy, I thought as I hung there halfway between life and death, just as Alison did two floors above me. How fitting that we end like all those celebrated star-crossed lovers that came and suffered before us. And as my legs slowly scaled the guardrail like a condemned man climbing the gallows, I saw Alison in my mind, much like I had in my dream, asking me to stop. I paused and watched as one more trickle of blood fell from my lips and held my breath, counting the seconds - one, two, three, four, five - until it made it's nearly silent splash in the obscurity below.

I climbed down from the guardrail, slumping to the stairs, defeated and heartbroken. I sat alone in that cold empty stairwell for almost an hour and wept like I never had before, mourning a life so beautiful, so precious and a love that would never be given a chance to bloom; my pitiful sobs, hushed by a floppy purple beret.

Alison's family arrived from Indiana later that evening and life support was withdrawn about an hour after. A fighter to the end, I was told that she held her own, much to the amazement of the ICU nurses, for almost an hour, before her exhausted body could take no more, finally succumbing to the illness that held her prisoner for over two years.

Alison Lumm, the tiny girl with the sad eyes and brilliant smile, was freed from leukemia at 8:32 that evening with her parents by her side, about the same time I was sealing the small cardboard box I had filled with seven hand written notes and one floppy purple beret. An ICU nurse told me Brian had been outside having a cigarette at the time of her death.

Alison's family brought her body home to Indiana for burial and on the day after her funeral, I received a phone call from her mother. She told me she was contacting all the doctors and nurses who had taken care of her daughter to thank them personally and added that I must have been special because Alison had mentioned my name "more than once or twice". I told her that "Alison was the special one" and left it at that. She thanked me once more before saying good-bye.

Brian moved the rest of his and Alison's belongings from the house they had shared and sold it to an older couple who always say 'hello' to me when I stand in front of their home longer than is polite. As far as I know, he is still with the woman he left Alison for as I have neither seen nor heard of him since that day in the ICU.

Like any wound, mine is slowly healing, but the scar, it will always remain. Not a day goes by that I do not think of the tiny girl with the sad eyes and brilliant smile. Work has, and never will be the same. I unfortunately care for my patients now with a dull sense of empathy, never getting to intimate with them nor letting them get to intimate with me.

On a piece of corkboard at the nurse's station, I have hung the Polaroid I took of Alison on the night we celebrated her birthday. When people who do not know of her ask me who the happy girl with the wonderful smile is, I simply say, "That is Alison. Isn't she beautiful?"

Some men yearn for just one more day with their lost love. Me, I ache for just one-day period with the woman I never had the opportunity to love. I sometimes wonder what life would be like if Alison had not died. I imagine the two of us on that beautiful sandy beach from my dream, running free and in love, living a lifetime in one perfect day. And when the full moon finally rises and that magnificent day meets its end, I feel Alison's tiny but warm hand on my chest, directly over my slowly healing heart, and I hear her words as if she were still right beside me. "Now I will never die Eric, because I will always live here."

No Alison, you never will die. I made a promise and until the day comes when I breathe no more and we meet again, you will never die because you will live within my heart.

Always.

**************

For Carrie - I have not forgotten.