It was a slow day on the floor and my patient, whose hair was falling out from chemo, had just asked me to shave his head.
“Sure,” I said, even though, despite the two years plus I’ve spent in oncology nursing, I had yet to shave anyone’s head.
Jeff Swensen for The New York Times Theresa BrownSome cancer patients find the process of waiting for their hair to fall out intolerable. Loose hairs fall into their eyes when they’re awake and tickle their faces while they sleep. During showers they feel awash in hair. At some point all the loose strands start to drive them crazy, and that’s when patients ask the nurse for a shave.
Patients worry a lot about losing their hair, but we nurses don’t think about baldness much. We’re so used to our hairless patients that we accept it as normal. Cancer drugs target quickly dividing cells, and that includes the cells in hair follicles. Patients tend to lose their hair 10 to 14 days after the start of chemo. It can take several weeks for it to grow back, but by that time they’re probably getting more chemo, so they end up being bald for a long time.
The patient today was a big guy, not overweight, just solid, in his mid-50s, with a boyish smile and a sly sarcastic streak that made me laugh. My friend Christi said she had shaved plenty of heads and offered instruction as well as moral support.
Shaving this patient’s head was probably as good as it gets for a first time. His wife insisted on taking pictures and tried to get me to leave him with a mohawk.
Afterward his wife asked if we could rustle up a hat for him, but really he didn’t need one — being bald suited him. Once I’d shaved his head and saw how he looked, the whole idea of hair seemed superfluous.
I shared with him this arch comment from Liz Tilberis, the former editor of British Vogue, who died at 51 of ovarian cancer: “Once you’ve had chemotherapy,” she had said, “there’s no such thing as a bad hair day.”
The next day, though, a different patient — this time a woman — asked me to get out the electric razor. She reminded me a bit of myself. She was roughly my age, 44, and had an 11-year-old daughter, whereas my twin daughters are 10.
Her hair was already fairly short, cut into an almost-shoulder-length bob. When the doctors had come in for morning rounds she had stood up and then, looking embarrassed, brushed off the layer of hair that had fallen out and covered her shoulders and back. She had been losing so much hair, she said, she felt like she was shedding.
That evening I got ready to shave my second head in two days, but the atmosphere in the room this time was completely different. Night had fallen outside, and my patient’s room, lit with fluorescent lights, held a lonely glow. Her husband had been with her during the day, but now she was alone.
I picked up a new blade for the clippers and grabbed a clean sheet to wrap around her like a barber’s cape. Before I started I asked if she wanted me to cut her hair short first before shaving it, but she said no, to just shave her head.
She was sitting in a chair facing one of the large windows in her room. Partway through she noticed a ghostly reflection of her half-shorn head in the window glass.
“Oh my god,” she gasped.
And suddenly I felt very awkward, even guilty, about what I was doing. I realized for the first time how difficult it can be to lose your hair as a byproduct of saving your own life.
But this woman, my patient, had asked me to shave her head, and so I did.
She didn’t say much — she was one of the more quiet patients I’ve encountered. But as her hair came off she revealed a few things. Her biggest worry was what her daughter would say. And she hadn’t told her husband that her head would be bald on his return.
When we were done, she headed to the shower to wash away all the small pieces of hair that were clinging to her. Meeting back in her room, I said, gently, “Well, you’re not crying.”
“No,” she said, “but that may come later.”
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