Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.
With one double-gloved hand I pull the unblemished skin of her buttock laterally. Holding a syringe in the other, I pierce the large muscle with a needle, injecting acid-yellow methotrexate deep inside. Its purpose is to deplete the tiny, nonviable embryo inside her of folic acid, preventing its growth, a rupture, and potential harm to the woman.
Usually I administer chemotherapy to stop the life cycle of tumors, not the rapidly dividing cells of an embryo that missed its mark, mistakenly lodged in a fallopian tube instead of finding its way into her uterus where both of them could have been safe. Ectopic, it sacrificed viability, and threatens the life of its host.
Prone on the stretcher after the twin injections, she cries quietly. I hand her a box of tissues. She blows her nose. I try to think of something comforting to say, something that lets her know this is sad for me too. Resources are limited, so the powers that be decided that the safety provided by a chemotherapy-certified nurse outweighs the education, skill, and emotional support provided by an obstetrics nurse. Most likely they’re right, but I feel badly that I know more about the mechanism of methotrexate than about resources for a woman in this circumstance—a reminder that being a nurse takes more than the ability to give an injection.
Later that evening, the patient discharged home, my shift ended, I carry tools of my other trade (charcoal, paper, and pencils) to a life drawing studio. I’m seeking a few hours of quiet meditation in the gestural rhythms of transferring life to paper.
The model, a young woman, poses naked on the platform. A bright light deepens shadows and highlights curves. The lift of her breasts, and a lack of stretch marks, inform me it’s unlikely she’s given birth.
With a piece of soft, black charcoal held between my fingers, I begin drawing the curve of unblemished breast onto a piece of paper, mourning a life that will never be.