As I moved into my new Hematology and Oncology office, I was full of thoughts, future plans, and ideas. Nadine, who had been my patient for the last few years, was one of the first to arrive at the new place. She came for her regular weekly Epogen injections. Nadine had a vibrant personality, one that was impossible to forget. In addition to her chronic renal insufficiency she also spent much of her adult life battling bipolar disorder. She was cheerful and supportive and these were the types of qualities envied in the waiting room. Although patients loved being in her high energy field, once she crossed the threshold into my examing room, her illness made me uneasy. She was loud, talked constantly in a pressured manner, and took a great deal of time. I began resenting her visits. I felt that she was taking time away from patients who were much sicker.
“So, this is the Doctor's new place! It is lovely,” she said. I looked at her anxiously waiting for a long conversation. She walked around in the office looking at the pictures on the walls of the waiting area. “Ralph left. He needed to be alone. He developed a new addiction “Internet'. You know those funny sites with all sorts of things….? We will always love each other, no matter that I feel empty… But enough of me! I am so happy for the doctor,” she said, drawing long on the word…doctooooor. “The office feels like home.” She went from picture to picture along the walls, paying careful attention to small details and commenting on what seemed like every color. She was sipping tea and seemed generally calm.
Nadine's long-time partner was Ralph. They had met years earlier in a psychiatric facility. They had mania in common, but Ralph also had a large measure of depression. He loved her; evidenced by the poetry she brought in and shared with me. He called her a “blue rose”. In some cultures, blue roses traditionally signify a never ending quest for the impossible. Blue roses are also portrayed in literature and art as a symbol of love and prosperity to those who seek it.
“Have I ever told you the story?” I didn't even swallow let alone answer before she dove into the story. She told her story so often that she didn't keep tally of who had heard it and how many times. Frankly, she didn't care. Even strangers knew the story. “Walking down the hospital hallway I saw him sitting on the floor. He was praying for the Armageddon to happen… I was full of energy, laughter and happiness… . We both were bipolar. He was depressed and I was maniac. Opposites attract… I put my hand on his thick and messy hair. ‘Is your head heavy?’ I asked. He smiled. We liked each other at first sight and started going for a walk together every day. Sharing stories from childhood, we became close friends.
“He told me about his hardship and how he got addicted to marijuana and cocaine. Ralph wrote poetry. Sometimes it was hard for me to understand what he was trying to say but I still enjoyed listening to him. We slowly fell in love and decided to move in together when we got out of the hospital. Ralph was a few years younger than me and sometimes I felt like a mom to him, or an older sister. I felt responsible for keeping him out of trouble. We first lived in a basement with no lease. We could be out on the street any day, but it was our home and we enjoyed every day spent together. Ralph was out of the psychiatric hospital for eight years, the longest stretch of his life. My mania was under control, but I was going through an extremely difficult time. My years on lithium triggered renal failure and I started on dialysis. I needed a kidney transplant… . Ralph watched my health worsen and decided to be tested if he could be a match. And he was!!! His doctor advised against it. ‘Not with your psychiatric illness!’ the physician warned. We went for the second opinion and the psychiatrist at Columbia University approved it. She asked a question we never thought of before: ‘What happens if you break up?’ We were in love. We were together. What could possibly go wrong?
The surgery went well. I fully recovered and did not need dialysis any more. My blood pressure was controlled with medications and I needed some maintenance immunosuppressive therapy. A lot of pills! Ralph managed my medications, went shopping, and cooked for me. This lasted for several years.
“Later, he just could not handle it. His addictions became worse. He was depressed, stopped eating and sleeping, and stayed up all night. He eventually got his own apartment and moved out to live alone. Now, we still do some volunteer work together and Ralph continues to write poetry to me.”
Nadine took out a framed poem that she keeps tucked in her pocketbook. I was still standing in the waiting room. Other patients now coming for their appointments took seats and occasionally looked up at the two of us. More so, they were watching my reaction to Nadine. She began reading the poem.
“The Blue Rose…”
