As a nurse in my early twenties, I worked with kids with cystic fibrosis (CF). At that time, we were just beginning to see some teens and young adults in our CF clinic. I was close to them in age, and friendships naturally developed. Some never even reached their twentieth year. I had never seen people my age die, and although as a nurse I knew this was possible and even likely because of their illness, every death was shocking to me.

It’s hard, then, for me to imagine how it must feel to have siblings with a terminal disease. It seems to me that losing just one brother or sister early in life would be devastating. What if you watched six die?

A childhood punctuated with loss.

In this month’s Reflections column, “No Illusion of Forever,” author and nurse Elizabeth Bruno shares her memories of her time with the brothers she lost to agammaglobulinemia. The earliest death was a brother who died at ten years of age; the longest living was her oldest brother, who lived to the age of thirty.

Part nurse, part mother—always remarkable.

Bruno’s mother, a nurse, seems to have had the clinical skill and extraordinary emotional intelligence to not only manage repeated illnesses and deaths, but to set a tone that helped her family thrive.

“I think my mother felt it her mission to normalize our lives as much as possible. While a very large room in our home was outfitted with hospital beds, mist tents, supply cabinets, and a medicine refrigerator, it also had a Ping-Pong table, television, and bookshelves overflowing with books and toys. “

‘If you loved someone, you let them know.’

Bruno notes that over the years, in her search for meaning after so many losses, she looked to her early family life. “If you loved someone, you let them know. If there were celebrations to be had, we did them to the max.”

Read this family’s story of resilience in AJN‘s December issue. The article will be free until December 28.