For Her. Always.

I remember vividly the sensation.

It's been so vivid and so intense, I've never been able to talk about it.

I was working night shift. I had been at the hospital since 3 pm the previous day, wearing the same bright pink scrubs. My co-workers had covered my shift because I was too much of a wreck to take my patients. I could barely breathe and they could see it. Before my shift even started, I had found my way into the tiny locker room and lost all composure in front of one the guys on the floor. He charged regularly and if I remember well enough, he was the charge nurse for day shift that day. The feeling of impending doom was all consuming and the fog hadn't taken over yet - but it was coming and coming fast.

I stayed in her room for hours, holding her hand. I took breaks to give her time alone with her husband and family. I had a doctor's appointment early in the morning and given the complexity of all the of the situation, I napped in the waiting area before briefly heading across town for my blood draw. In 20 minutes, I was back at the hospital, preparing to wait and hold more hands.

At this point, her mom had made it from Oklahoma and the hospitalist was rounding. Months prior, she had given me clear instructions for if this moment occurred. She was sick then, but there was hope and the idea that this was going to happen was ludicrous. I was never supposed to actually have to do this. The hospitalist who was taking care of her wasn't working his typical hospital duties for her though. He was in charge of her comfort, helping her transition, helping us prepare for those last few hours, minutes, and moments.

It was a small white room with two accent chairs, an armchair, and a love seat. Tissue boxes were in every corner. There was no telling how many countless family members had been in here with Dr. P having the exact same conversation. I sat down next to her mother-in-law, holding hands. Her mother was in seated in an accent chair, furiously crocheting without breaking eye contact. Her husband was in the armchair, silent, grave, and fully in the fog. Dr. P gave us his assessment. He knew me, he talked to me while I watched David. I translated.

David finally looked up, completely stoic. A silent question.

"We can't leave her as a full code, David. They will kill her with the compressions. This isn't what she would want. We can't put her through that trauma." I tried to keep myself composed, for him, for Mary, and for Linda. I could not get enough air in.

He only nodded.

I looked to Dr. P, "We want to make her comfort care."

In that very moment, despite all rational thought, I felt like I had just killed my best friend.

But that wasn't the truth. The truth was she had tried just one more treatment. She had gotten just one more infection. She had needed just one more unit of blood. She had needed one more miracle.

She had always told me while she was sick that she had complete faith that she would be healed.

Healed completely.

She had faith that she would have this terrible disease taken from her and she would be full of life.

Faith is a genie sometimes; the results may not be exactly as you had believed in, but the result is still technically the same.

She was about to get that one last miracle. She was receiving her complete healing. Just not in the way we had hoped and prayed.

It was early in the morning still. Not even 9 am.

I took my coffee and told David, Mary, and Linda to take their time in the family room. I would deliver the news for them. They didn't have to be strong right now and they could go soak in every second with her.

I collected myself after closing the door and went to Dr. P. "Thank you for making my duty easier. I don't want her hurting anymore." His nurse hugged me. All the MICU nurses hugged me. We all knew each other, we worked directly across the hall from each other. My nursing friends were keeping me together, as nurses do. In return, I had promised to make sure the 2 visitors per room policy was rigidly followed given the deluge of family and friends waiting for an update. She was oh so loved, the way she had lived her life loving on others.

I made my way to the waiting room. There were so many people there now. People I knew and more people I had never seen before but knew exactly who I was. Faces I had never seen calling me by name, asking me for an update.

"What's the latest, what did the doctor say?"

The funny thing about faith with people who don't know medicine is how tragic it is when we don't get what we pray for. No, it's not funny, it's just tragic.

"She is very sick. She has sepsis, her blood has a lot of bacteria in it making her very ill. She does not have the white blood cells in her to fight off an infection, even with the help of medicine. She's not waking up anymore and she's so fragile that if we continue to treat her, we can actually make her more uncomfortable. So David has decided to make her comfort care. They will stop giving her medicines that would treat the infection and they will start giving her medicine to keep her as comfortable as possible. She's not waking up anymore, she's not responsive. This tells me that we don't have long. David is with her now and when he comes out, we will start letting other family go in two at a time to say goodbye."

The tears. How did I speak the words over all of their tears? I'll never know. I wish I knew where this ability to turn off my emotions existed in my head.

My husband was there. We'd only been married a few months. She was so beautiful on our wedding day, and my God she was stunning at our rehearsal dinner. Glowing even. Happiness tends to make people gorgeous. I don't remember when he did, but he was holding my hand, waiting for me to crumble back into pieces.

Linda had made her way back into the waiting area, still stemming with her crotchet needle. I don't remember if she was making a scarf or a sweater, she was making an insane amount of progress on this piece. I want to say it was a red scarf... I wonder if that's correct.

Mary came and tapped my shoulder. "David said you can come back now."

I nodded and collected Linda.

Her room was freshened up and several of the IV poles had been removed. The monitor had been silenced and her vitals were terrible. Her blood pressure was so low. I slid the glass door shut and pulled the curtains after David stepped out. He was going back to the waiting area to check on their 3-year-old daughter.

Linda stood on her right side, I was on her left, holding her hand. Her oh, so swollen hand. She looked like an angel. No sign of discomfort to be found. Her breathing was staggered but quiet. She was wearing the pendent of St. Peregrine I had given her.

Her mother was so strong, matter-of-fact even. Giving my best friend her good byes were as if she were giving her clear instructions for her grand heavenly entrance.

I cried her tears for her, my cheeks were soaked.

I remember two of our last conversations before she was septic.

One was at her house, on her couch. She was laying in her favorite down comforter borrowed from a friend, another cancer-survivor. Her crocheted hat was on her head and we were solemn but laughing. As always, laughing. We knew this was our last conversation and said the things we needed to say.

The other was at my house, before she was too sick to leave her house. It was around Christmas. We were sitting at my kitchen table, sipping coffee and telling stories on our husbands. She gave me one last gift, a gift that changed the course of my life entirely. A recommendation I immediately purchased on Amazon when she left.

"I love you. You are the best friend anyone could ever have. You have carried me through so much and have glued me back together. I am a better person because of you. And because I know you can still hear me, I have to tell you that I got those pee strips you told me about. I wanted to tell you this when we got coffee the next time but seeing as you had to go and get septic, I need to tell you this now. I'm pregnant. Adam and I are having a baby and I wish you didn't have to go already."

Her mother's composure hiccuped with stifled moan as she looked away.

I had only told Adam as I was only 5 weeks and had found out just a few days prior. I had a history of poor outcomes and that earlier doctor's appointment was to confirm my hormone levels. For the first time, my hCG levels were in the right place. This baby had a chance.

"I need you to tell God when you get there that this baby was a team effort, OK?" I sobbed into her ear. In my heart of hearts, I still believe she heard every word of it. And I believe she squealed with delight. Because that's who she was, a beautiful soul that poured all of her love into others. She gave of herself so others could have more. She served others to her very last days.

Time started to stop at this point. Exhaustion was taking over and the coffee wasn't able to fight. My own unit had a family room, a little larger and just off from the waiting area. I had to nap or I was going to fall over. My husband had gone home for a few hours and since I had I refused to leave the hospital, I laid down on the couch of our family room to try to shut my eyes despite my grief.

All I could do was pray. And pray.

And pray harder.

Then there was a knock on the door. I blinked my eyes open; I had fallen asleep.

The knocking became more fervent.

"Stephanie, we need you," Mary was urgent. "Something is happening."

I opened the door to the bright light of the hallways, confused. I had been asleep for maybe 3 hours. Mary said she didn't want anyone to wake me.

"Something is happening, we need you," and we ran to the MICU door, slamming my badge against the automatic lock to get us in as fast as possible.

Every step was like walking in a time warp. My arms swung in slow motion. I turned the corner, not seeing anyone but seeing everyone staring at me at the same time. Her nurse was standing at the curtain, patiently standing but ready to close the door behind us. The walk across the nurses station took what felt like hours as my heart beat pounded into my throat.

It was 3:20 pm.

24 hours since I'd met her in the emergency room with David, upside down on a bed because her blood pressure was so low.

Everyone was standing at the end of the bed.

Everyone but David.

David was standing over her, sobbing.

I was the last of the inner circle to make it into the room.

The monitor. I looked up and I saw one heart beat. Then nothing.

Once all of her loved ones were in the room, she had taken her last breath and her heart stopped.

So silent.

So foggy.

Distantly, I could hear Mary and David. Linda was standing near a corner and next to her at the same time. People were standing at the end of the bed. I was standing at the end of the bed by myself, but I don’t know how I made it there. All of it, all of it simultaneously happening in the fog. In the reality that my best friend was gone.

She still looked like an angel. So peaceful.

In that moment, I could not stop staring. I could not stop processing. But I also couldn't process anything.

David grabbed me and hugged me, so tight. His mother was hugging me, too. We were all hugging, all sobbing.

She was gone.

Inflammatory breast cancer had taken my friend from Girl Scouts, my high school buddy, and the person who had fixed the cracks in my foundation when my whole world had shattered four years prior. The disease had no right to take her from me, but it did.

And so today, I fight for her.

The summer before she died, on one of our many Barnes and Noble coffee dates, she handed me some note pads and pens with "Hope, Faith, Cure" written on them. She had designed them after meeting a new friend, Terry. Terry had founded The IBC Network Foundation and had lit a fire in my friend to tell more people about Inflammatory Breast Cancer. She was passionate to tell her story so other women can learn and hopefully be able to advocate for themselves to get faster identification and treatment - God forbid they were to be diagnosed with this rare disease.

Because, again, that's who she was. Always giving of herself as if she was an endless Mary Poppins carpet bag. There was no end to her love of others.

Today, I write for her. I tell her story. I tell everyone I can. I tell them about our coffee dates and love of trash novels. I tell them about penis cookies and painting shutters while inebriated. I tell them about dance parties and cuddling in a bed watching Law and Order reruns. I tell them about sneaking shots into movie theatres and Mexican food and bread pudding and pregnancy photos the day before her scheduled c-section in the peak of August heat in Alabama.

I tell my son, now 11, about her. I tell him how he got his name and why it's so important to me. I tell him she's her guardian angel, always looking out for him. I show him pictures and fight back the tears when I remember all of those magical memories.

So who was this girl with the beautiful, thick, blond hair who sat in the desk in front of me in 9th grade homeroom? The girl who turned around and smiled this bright smile, with the sweetest voice, who said, "I know you from Girl Scouts"? This was the girl who made sure I had a friend in a new school. She was the friend who hugged my neck when I saw her hosting at a restaurant. This was the girl who taught me about Odo ban and the Insanity workout. This was the girl who came to my apartment and ordered Chinese food when I was a shell of myself after my divorce and the girl who created jobs for me in her husband's catering company so I could pay my bills. This was the girl who made any excuse to get some cheese dip or a coffee. This was the girl who I could go weeks or months without seeing and catch up with as if we had never missed a minute of each other.

This was Heather.

Heather at my rehearsal dinner.

This is one of my stories of Heather. I have so many stories to tell. For the first time in over a decade, I've just now found the courage to write them down. This isn't just for the grief that I carry everyday since 2014. This is to share her story and hopefully continue her mission to teach others about IBC. To learn more about Inflammatory Breast Cancer, please visit The IBC Network Foundation. To help be her voice, please tell someone what you learn.

About the Author

Stephanie Pilkinton, RN, MSN, FNP-C, PMHNP-BC

Founder of Sweet Tea & Science | Nurse Practitioner | Writer | Wellness Advocate

Stephanie is a dual-certified nurse practitioner with a passion for blending evidence-based medicine with everyday life. She believes wellness should feel approachable, not overwhelming — and that a little Southern comfort and curiosity go a long way.

Follow her journey and join the conversation at Sweet Tea & Science.