Tonight I wanted to share from the first edition of my book, The Last Adventure of Life. It's one of the most powerful stories in the book - a poignant article from the American Journal of Nursing
that came to my attention thanks to a hospice R.N. The
nurse shares in this piece a thought-provoking incident she was a part of when she
encountered a dying man on her shift at the hospital. More than
anything he needed compassion, and yet she felt she was unable to
provide this for him in his last moments of life. She may have provided more than she realized by her very presence, even though
the hospital’s protocol left much to be desired. I found myself
wondering how things could have been different for this man’s last
hours on earth if he, his doctor, and his family had started a
conversation about his death much earlier. Then, he might have been
able to be on a hospice or palliative program when the following
circumstance unfolded.
No Time
for Answers: When Clocks and Heartbeats Pause
Mike
Soreneson was the second patient on my initial rounds that afternoon:
A man in his fifties, youngish but with a tired heart. From the
doorway, I could see his distress. It filled me with dread. He was
drenched with sweat and his breathing was labored and choked with
rattles. Fear was in his eyes. I knew from a report that he’d
already suffered two myocardial infarctions, and it was clear that
his damaged heart, stretched and weakened from cardiomyopathy, was
rebelling against its unrelenting workload.
It took just
a nanosecond to sprint from the door to his bedside, apply the blood
pressure cuff, and push the call light in frantic summons of the
cavalry. Before it arrived, in those seconds that dragged with
waiting and the taking of vital signs, he grabbed my wrist and turned
his bewildered eyes toward me. Struggling to sit up, he whispered in
a voice tight with
panic, “Where am I? What’s happening to me?” There was no time
for answers as he crossed quickly into the shadows.
Time can
stop. It did that afternoon. In that diastole of realization—when
clocks and heartbeats pause—I saw him wonder at things beyond my
mortal edges. And then, in a finger snap, his eyelids flickered and
drooped, and he sighed once before leaving me suddenly alone.
Tensions and years eased from his face. He became youthful and
handsome, with the promise of life seeming to stretch before him.
As
he fell back slowly onto his pillow, the world rushed in:
resuscitation, in its chaotic and technical splendor, took control.
The room filled abruptly, people crackling with energy arriving
together as if from the same train. White coats snapped like battle
flags. The code cart, red and bulky, was pushed squealing into the
room; a defibrillator and an electrocardiogram machine followed
quickly around the corner. A leader barked orders. Sterile packages
were ripped open and disemboweled. Mike’s body was stripped and
assaulted with needles and tubes. White adhesive tape fringed the
room, and us, in little strips, while drops of his blood, imbued with
drugs that proffered false hope, rubied sheets and shoes. Paper
banners snaked and curled around our feet, documenting the story of a
dying heart in unemotional peaks and valleys. Then, straight lines. A
life ended.
As the code
stopped, I was standing where I started, next to a heart I had
compressed and shocked yet never known. The cavalry scattered, as the
empty room filled with the smell of defeat. I trembled with
adrenaline, yet felt drained. After removing tubes, catheters, tape,
and electrodes from Mike’s body, I covered him with a clean sheet
and began to clear the debris. Strips of tape had wandered away on
the bottoms of shoes to other units, other crises, as this corner of
the hospital settled back into familiar routines.
A colleague
helped with postmortem care. We talked of the code as if in instant
replay, even sharing quiet, guilty church laughs about comedic
moments. We didn’t speak about Mike. We didn’t know him. We
treated his body with professionalism and respect, but without
memories or words of goodbye. I didn’t tell her about his fear. I
didn’t mention his last words. They somehow seemed too raw and
private, still undigested in my mind.
For weeks
after Mike’s death, his impersonal end filled me with sadness and
regret. I wish I had comforted him in his final moments—did he
recognize my detachment, and feel one final, mortal ache? In the
many years that have passed since that afternoon, I’ve made an
effort never to shrug away compassion. With every finger-squeeze of
thanks, I was enriched.
And I hope that when my death is near—before stepping into bright
beginnings or overwhelming silence—I will feel a caress on my
cooling cheek, or smell the salt of a single tear. Smiling, I will
turn from the shadowlands to see someone who loved me, standing in a
pool of soft porch light, hand raised in goodbye. -- Pamela
Sturtevant, R.N.
There
is a land of the living and a land of the dead and the bridge is
love,
the only survival, the only meaning.
—
Thornton Wilder
