The Presence of Paul Corby
What the life and death of a young cancer patient meant to the staff of Weinberg 5A.
Paul arrives at the Sidney Kimmel Comprehensive Cancer Center in the early days of September 2001 and is admitted to Weinberg 5A. The staff immediately takes to him.
"He was just the sweetest kid, happy and good-natured," says MiKaela Olsen, clinical nurse specialist on the unit. "He was not your typical teenager with cancer. He had every right to be selfish and feel victimized, but he never did."
Laura Hoofring, the psychiatric liaison nurse for medical oncology, was asked to see Paul because of his diagnosis and his age. "People were worried," says Hoofring, a nurse for 22 years. But what she discovered was "one of the bravest people I've ever met. I'll never forget him." By the end of Paul's nearly year-long battle, Hoofring had spent much more time counseling the nurses on 5A who worked with Paul, many of them young enough to be his peers.
Inside Paul's room, the lights are out and the shades completely drawn, because Paul is photophobic. Even daylight hurts. It is July 18, and every attempt at therapy has failed. There is nothing to do but try to relieve his unrelenting pain.
It is hard to believe the person in the bed-bald, distended stomach, nearly voiceless-is only 20. Paul's father, Patrick Corby, sits by his eldest son's hospital bed, and wearily begins to tell their story. The family chose to come to Hopkins, where 30 cases of Burkitt's lymphoma (out of roughly 300 nationwide) are treated a year. Paul's initial course of chemotherapy was lengthy and intense, but seemingly successful. Just after Christmas, a cancer-free Paul was sent home with a clean bill of health. "We were ecstatic," says Patrick, a superintendent for the Land O'Lakes dairy plant in Carlisle, Pa.
The good news was cruelly short-lived. Only three weeks later, Paul experienced excruciating headaches. "No pain medication would touch it," says his father. He was readmitted to the hospital, and the cancer was found to have spread to his central nervous system.
If the medical team could clear up Paul's CNS, they would attempt a bone marrow transplant. But nothing in the course of Paul's treatment seemed to go well. Twice, the port in his skull used to deliver medication got infected. After the infections cleared, Paul received another course of high-dose chemotherapy. But it was too late. "His body couldn't tolerate any more chemo," says Patrick, "and we were told he had three to four weeks to live."
The week before Paul died, Patrick Corby couldn't explain his feelings. "We have no answers," he said numbly. "We don't know why he got it; we don't know why he can't get rid of it."
From the start of his stay at Hopkins, Paul and his family bonded with nurse Tim Eden. "He related to me, being a guy," says Eden, 26. "He had an easier time talking to me." They razzed each other about their hometown football teams throughout the NFL season.
Paul was "very much a jokester," says Eden. At the beginning of one shift, Paul and one of his younger brothers swapped sleeping arrangements. When Eden walked in and Paul's brother jumped out of the hospital bed, Eden yelped.
Paul was known for an abundance of friends, who would visit in droves. "They'd take up a whole section of the waiting room-we called them 'Paul's people'-and they would be laughing," says Laura Hoofring. "They were a reflection of Paul."
During the last several weeks of his life, Paul began putting everything in order. He had the Weinberg staff help him secretly arrange an anniversary dinner for his parents. ("He felt like it was something he could do for them," says MiKaela Olsen. "They'd done so much for him.") He personally selected his pallbearers from among his friends. But there was still something he wanted desperately to do.
When Paul was still well, he had helped his best friend, Eric Mentzer, a part-time landscaper, build a backyard pond. Paul liked it so much, he wanted one, too. He never had the chance, so a bunch of his teen-age friends dug up the Corby's yard instead and engineered an elaborate, dual-level pond with a cascading waterfall. Paul's last wish was to go home to see it.
But making that happen was no easy task. Nurse manager Gina Szymanski cleared the hurdles and made Paul's complex transportation arrangements with Lifeline (better known as "the purple people").
"No one realizes what we gave him by letting him do that," says Olsen. "It was more valuable than any test we could've done."
That day, July 17, Paul was "in his element," recalls his father. "There were more than 100 cars up and down the block lined up to see Paul and dedicate the pond to him. It was a dream come true."
The next day, Gretchen (not her real name) stops by to see him. Paul has been unresponsive to other visitors until he hears her name. Then he struggles to get presentable and greet her. She is 19, and has become Paul's friend, as they've battled cancer together on Weinberg 5A. She is wheeled over to the side of Paul's bed, and begins to weep.
"They go into each others' rooms and talk about dying," says Olsen. "Paul says to her, 'It's gonna be OK, because when you go to heaven, I'll be there, too.' She says, 'How will I find you?' Paul answers, 'We'll find each other; it's a pretty big place, but we'll find each other.'
"It's hard to be in the room with the two of them. But it's educational and very meaningful. They know they're dying, and they're sharing their ideas about how scary that is. Their best support is each other."
As the days wear on, the atmosphere on the unit becomes raw. The staff needs comforting. Hoofring reminds the nurses about professional boundaries, warns them not to visit the unit on their days off, to store their energy for work. "I've spent a lot of time talking to them about what they can and can't do for patients," says Hoofring. "I know I can't save Paul. But what I can offer is to be there, to hold his hand, to laugh and cry. That's all. But that's a lot."
On July 25, Paul Corby died. There were about a dozen people in his room-including his high-school basketball coaches. The staff stopped to say a prayer, but almost immediately had to go back to work. Many of them attended Paul's funeral in Carlisle, which was immense. One nurse was determined to attend even though she was working back-to-back nights. She slept that day in the car.
A few days later, Gretchen died, and the staff of Weinberg 5A was feeling numb.
Laura Hoofring philosophizes: "When people get a diagnosis of cancer, their lives are devastated. But what I find amazing is how people take that devastation and make riches out of it. It's such an honor to be a part of their lives at such a time. That sustains me. I get so much more than I ever give."