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‘This is not a study. This is my life.’ A nursing student’s final words to the profession (part 2)

Alysha Ramus received her degree before dying of cancer in 2020

By Alysha Ramus
March 27, 2023
Courtesy of the Ramus family
“The hardest part of dying for me is the inability to be there for the ones I love after I am gone. All my life I have been there for my parents and the people I love, protecting and supporting them. But this time I am not going to be able to do that. That is the scariest part of dying,” Alysha Ramus, far right, wrote in her school assignment. Alysha is shown here with, from left, her sister Paige, her niece Kennedy, her mother Michelle, and her niece Raelynn.
Editor’s note: Alysha Ramus was a nursing student at the University of Lethbridge when, at age 25, she was diagnosed with cancer. She fulfilled her academic requirements, including submission of this final assignment, and received her degree in March 2020 in a special convocation ceremony in a hospital. Alysha lost her battle with cancer on July 15, 2020. Her family granted Canadian Nurse permission to publish her school work. This is part 2 of 3. Part 1 was published on March 20. Part 3 will be published on March 29.

Things you have to learn to live without (the future is unpredictable)

Courtesy of the Ramus family
Nursing school photo of Alysha Ramus.
  • Loss of the future
  • Places in the world I will never see
  • Movies I might never get to see
  • Leaving things unfinished; I am in the middle of my life, and it will all be lost
  • I have no control over the future, and this is brought to a big reality
  • Letting go of all the plans I made that will never happen
  • The future I had planned is gone, the future my parents envisioned me having is gone
  • All the milestones and successes that I will never get to pass or see others pass
  • Being there for my nieces’ and nephews’ lives, missing them growing up
  • Losing the future with my dog
  • Losing the future with the man of my dreams, my one true love
  • Not growing old and celebrating more birthdays
  • Not being able to get married
  • Not being able to have children

“I hope all of you get to read my paper wherever it ends up,” Alysha said as she accepted her nursing degree. Listen to Alysha deliver her speech (with transcript).

Leading up to the diagnosis

I used to feel strong, that I knew what I was doing and had a plan. Now I feel lost. That strength and plan were taken away from me. I feel weak now, like a baby. Cancer takes away YOU. I had worked hard and was close to accomplishing my goal. Within days, I lost it. You kind of know what the diagnosis will be, but then they say, in one sentence, “You have cancer.” I’m 25. How do I have cancer? I’m healthy.

How my journey began…

March 2019: I had pain and tightness in my chest when breathing and was admitted to hospital. Pericarditis was a possible diagnosis (fluid around the heart). It was drained with a pericardial effusion. This is how my journey began. The doctors said they don’t know the cause in one in three cases, and I went home. I had no idea how my life was going to change and poured all of my energies into my nursing studies.

August 2019: In August, the pain came roaring back. I spent two days, then five days, then five more days in the hospital. The fluid on my heart came back twice and was drained twice. Every test was coming back clean. “It must be a virus,” they said. I felt tired and defeated. I felt frustration whenever this interrupted school. I was in my second-last semester toward earning my bachelor of nursing from the University of Lethbridge. My professors were very understanding and helpful, but my whole semester was being interrupted.

September 2019: In September, it was decided to leave the drain in for the weekend when the pain sent me to the emergency department again. The fluid was back. “Rest. Take it easy” were my instructions. I could attend classes but couldn’t keep working. I had to keep the stress down.

October 2019: October is when life as I knew it would never be the same. Stabbing back pain, a trip to the emergency department, the discovery of nodules on my lungs. So many tests: a chest CT, chest x-ray, endoscopy. A mass on the back of my heart, an ambulance from Lethbridge to Calgary, the possibility of open heart surgery.

I was overwhelmed with how fast things were moving and worried about surgery interfering with school. There were lots of tears when communicating with my parents and friends. My stomach was in my throat; it was like being on a plunging roller coaster. Suddenly, everything was different. I had things to arrange, such as pets, my partner’s work, school, my home, rent, roommates, and car, letting my parents know when I was going to arrive to stay with them, my family arriving at the hospital. There was a lot of uncertainty.

Hurry up and wait

After October 2019, I stopped measuring these events in months. Instead, I measured them in days and hours.

Friday: About a dozen invasive and painful tests.

Saturday: A bone scan on my knee. It’s my 25th birthday. “What’s wrong with my knee?” These words shifted my reality: the resident said, “It’s most likely cancer that has spread to your bones, but we won’t know for sure until the biopsy.”

Monday: I phoned my aunt to come to Calgary. My mom was going to need support.

Tuesday: A bone scan. My boyfriend had to call my mom. She could hear me crying. It was probably cancer, but we didn’t know for sure. The biopsy was to be done right away. Another painful procedure: the biopsy from my lung. We had to WAIT again, 24 to 48 hours, for these results.

Thursday: Stage 4 cardiac angiosarcoma. My boyfriend was with me. My family was by my side soon after. I got news of cancer and acceptance of my desired preceptorship spot the same day. I’d worked so hard to get that spot. I’d have to let it go. Kicked when you’re down. Happy f*ing birthday to me. Life as I knew it was over.

Friday: The oncologists would meet on Monday to determine my treatment plan.

How do you take stuff like this in? My life crashed in front of my eyes. Stage 4 cancer had spread from the original spot through my body.

Monday: The doctors shared my treatment plan. It is a very rare cancer.

Tuesday: I started chemotherapy. This is my new normal: chemo on Tuesdays, blood work and clinic at the hospital on Mondays. I’m on oxygen and have a portable tank. The tank lasts an hour and a half.

Courtesy of the Ramus family
Alysha Ramus with her mother, Michelle.

I don’t want cancer to define who I am

The people around me

Relationships change

  • Spouse
  • Friends
  • Family


Sometimes you just want people to just say, “I’m sorry; this sucks,” instead of things like:

  • “It happened for a reason.”
  • “You are strong, and you can fight this.”
  • “Kick cancer’s butt.”

I know people say these things to be supportive. Maybe they say them to make me feel better or to make themselves feel better. But in cases like mine, it is not really about them; it’s about me, the person who is sick. I know that talking about dying and cancer makes people uncomfortable, but that does not mean we shouldn’t talk about them. It means we should talk about them more. We need to break the stigma. If you know someone with cancer, talk about it. Anyone who has cancer and/or is dying should be able to be candid with the people around them. I should feel 100 per cent supported with any way I am feeling, and people who hear that should be able to react however (sad, happy, angry) it makes them feel.

Sometimes when we are ill, we bottle up our feelings because this is what we have been taught to do: keep our problems to ourselves. Because of this societal norm, it makes it hard for me to express these feelings, and when I do, it makes people feel uncomfortable. But I have learned that it’s okay if I make people feel uncomfortable. It’s not my responsibility to make other people feel better about my cancer. Cancer is not a fight anyone should have to battle alone. Listen when I want to talk, be real and don’t pretend.

The hardest part of dying for me is the inability to be there for the ones I love after I am gone. All my life I have been there for my parents and the people I love, protecting and supporting them. But this time I am not going to be able to do that. That is the scariest part of dying. It is not the fact that I will be gone; it’s the people whom I will be leaving behind who have the hardest job. Losing me will be something they have to live with for the rest of their lives. I have never felt this helpless in my life, and it is incredibly hard. I have been doing my best to get them as ready as I can, making sure I help them get their ducks in a pond, not in a row. As long as we can get them mostly in the pond, I will feel like I have done my job. When I am gone, everyone else will need to be ready, will need to heal. Be vulnerable together, really listen to each other and be real.

This is part 2 of 3. Part 1 was published on March 20. Part 3 will be published on March 29.

Canadian Nurse thanks Alysha Ramus’s family for granting permission to publish her work. To learn more about Alysha, you can watch this interview by Global News.