Cone Shaped Hats, Cake and Chemo 101

It’s my patient’s 13th birthday. She is propped up in a wheelchair, cone shaped hat on her bald little head, mask on her pale face. She seems nauseated and in pain. She looks tired and miserable and I wonder why we’re having this party. Then I look at her mother, beaming as she’s taking pictures and dishing out platefuls of cake to everyone she sees. She claps with such love and joy and pride when we finish singing Happy Birthday– I realize this is one birthday party that isn’t for the birthday girl. This is it. This is her baby’s sweet 16, her high school graduation, her wedding, her baby shower all rolled into one. This is every milestone she’ll never get to have. She may not fully comprehend this, but her mother does. What do you do for a 13 year old at her last birthday party? What do you do for her mother? You take a piece of cake you don’t really want, you sing happy birthday as loudly as you can, and you smile even though you want to cry. They don’t cover this in nursing school.